Provider Demographics
NPI:1891116927
Name:KNEESSI, ANDREA (DC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:KNEESSI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 LIVINGSTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4908
Mailing Address - Country:US
Mailing Address - Phone:240-766-0300
Mailing Address - Fax:240-766-0304
Practice Address - Street 1:1730 WEST ST UNIT 205
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3764
Practice Address - Country:US
Practice Address - Phone:443-808-8948
Practice Address - Fax:443-837-6354
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03766111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
1891116927OtherNPI