Provider Demographics
NPI:1598400228
Name:KNAPP, ANTHONY JOEL
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOEL
Last Name:KNAPP
Suffix:
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 1:65 MCOWEN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4225
Mailing Address - Country:US
Mailing Address - Phone:937-560-9494
Mailing Address - Fax:
Practice Address - Street 1:65 MCOWEN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4225
Practice Address - Country:US
Practice Address - Phone:937-560-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0002798175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist