Provider Demographics
NPI:1629397435
Name:KNOP, ANNIE
Entity Type:Individual
Prefix:MISS
First Name:ANNIE
Middle Name:
Last Name:KNOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 13TH ST S STE 110
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:MN
Mailing Address - Zip Code:55328-9404
Mailing Address - Country:US
Mailing Address - Phone:612-685-0211
Mailing Address - Fax:762-972-3734
Practice Address - Street 1:327 13TH ST S STE 110
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:MN
Practice Address - Zip Code:55328-9404
Practice Address - Country:US
Practice Address - Phone:612-685-0211
Practice Address - Fax:762-972-3734
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist