Provider Demographics
NPI:1538325014
Name:KNAPP, JEFF DUANE (DC)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:DUANE
Last Name:KNAPP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 VERA DR
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-9823
Mailing Address - Country:US
Mailing Address - Phone:517-437-4767
Mailing Address - Fax:517-437-0567
Practice Address - Street 1:1384 VERA DR
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-9823
Practice Address - Country:US
Practice Address - Phone:517-437-4767
Practice Address - Fax:517-437-0567
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJK009485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11873289OtherCAQH
MI9602183OtherAETNA
MI950C010720OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MIP00646397OtherPALMETTO RAILROAD GBA
MIPENDINGOtherCO-FINITY
MI5259313OtherCIGNA HEALTHCARE
MI1174771745OtherTYPE II NPI
MI9602183OtherAETNA