Provider Demographics
NPI:1538129986
Name:KNAPTON, GREGORY WAYNE (PT ATC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:WAYNE
Last Name:KNAPTON
Suffix:
Gender:M
Credentials:PT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BRIDGTON RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3653
Mailing Address - Country:US
Mailing Address - Phone:207-797-3477
Mailing Address - Fax:207-797-8577
Practice Address - Street 1:23 BRIDGTON RD
Practice Address - Street 2:SUITE 2
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3653
Practice Address - Country:US
Practice Address - Phone:207-797-3477
Practice Address - Fax:207-797-8577
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2005225100000X
MEAT2452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME626281OtherHARVARD PILGRIM
ME041387OtherANTHEM
ME2756063OtherCIGNA
ME206530Medicare ID - Type Unspecified