Provider Demographics
NPI:1477525079
Name:KNIGHT, KENNETH L (PHD, ATC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:L
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 SFH ATHLETIC DEPARTMENT
Mailing Address - Street 2:BRIGHAM YOUNG UNIVERSITY
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84602
Mailing Address - Country:US
Mailing Address - Phone:801-422-2984
Mailing Address - Fax:801-422-0555
Practice Address - Street 1:271 SFH ATHLETIC DEPARTMENT
Practice Address - Street 2:BRIGHAM YOUNG UNIVERSITY
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84602
Practice Address - Country:US
Practice Address - Phone:801-422-2984
Practice Address - Fax:801-422-0555
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer