Provider Demographics
NPI:1891732095
Name:KNECHT, ANDRE NMN (DC)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:NMN
Last Name:KNECHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 S HORNER BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-8032
Mailing Address - Country:US
Mailing Address - Phone:919-777-5242
Mailing Address - Fax:919-776-7494
Practice Address - Street 1:2631 S HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-8032
Practice Address - Country:US
Practice Address - Phone:919-777-5242
Practice Address - Fax:919-776-7494
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2428111N00000X
NYX008013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0828TOtherBCBS
NC890828TMedicaid
2451608BMedicare ID - Type Unspecified
0828TOtherBCBS