Provider Demographics
NPI:1750819256
Name:KNOTT, DAWN MARIE (MS,PT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:KNOTT
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:MISS
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:CLULOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,PT
Mailing Address - Street 1:1670 LOCKPORT OLCOTT RD
Mailing Address - Street 2:
Mailing Address - City:BURT
Mailing Address - State:NY
Mailing Address - Zip Code:14028-9769
Mailing Address - Country:US
Mailing Address - Phone:716-930-9665
Mailing Address - Fax:
Practice Address - Street 1:ELM AND CARLTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022640-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist