Provider Demographics
NPI:1629299276
Name:KNOCHEL, FREDERICK LEE III (DC)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:LEE
Last Name:KNOCHEL
Suffix:III
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 1:2525 WASHINGTON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-4690
Mailing Address - Country:US
Mailing Address - Phone:989-832-2349
Mailing Address - Fax:989-259-1360
Practice Address - Street 1:2525 WASHINGTON ST
Practice Address - Street 2:SUITE 500
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-4600
Practice Address - Country:US
Practice Address - Phone:989-832-2349
Practice Address - Fax:989-832-2375
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIFK008865111N00000X
MI2301008865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4722443Medicaid
MIP00110001Medicare ID - Type Unspecified
MIV01772Medicare UPIN