Provider Demographics
NPI:1518202274
Name:KNAPP, ROBERT L III
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:KNAPP
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 JOHNSON AVE
Mailing Address - Street 2:STE 4N
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1063
Mailing Address - Country:US
Mailing Address - Phone:304-842-3050
Mailing Address - Fax:304-842-5733
Practice Address - Street 1:1400 JOHNSON AVE
Practice Address - Street 2:STE 4N
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1063
Practice Address - Country:US
Practice Address - Phone:304-842-3050
Practice Address - Fax:304-842-5733
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF0308100237700000X
WV853237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist