Provider Demographics
NPI:1710999263
Name:KNAPP, ROBERT MILES (BS, DC, CCST)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MILES
Last Name:KNAPP
Suffix:
Gender:M
Credentials:BS, DC, CCST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4512
Mailing Address - Country:US
Mailing Address - Phone:703-823-2201
Mailing Address - Fax:703-823-2203
Practice Address - Street 1:2817 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4512
Practice Address - Country:US
Practice Address - Phone:703-823-2201
Practice Address - Fax:703-823-2203
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA142287Medicare PIN