Provider Demographics
NPI:1821574492
Name:KNOTTS, KAYLA (OD)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:KNOTTS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:73 BARRETT ST APT 5185
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-1719
Mailing Address - Country:US
Mailing Address - Phone:765-635-7979
Mailing Address - Fax:
Practice Address - Street 1:269 LOCUST ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-2003
Practice Address - Country:US
Practice Address - Phone:413-584-6666
Practice Address - Fax:413-584-7428
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34090TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist