Provider Demographics
NPI:1902819600
Name:KNIGHT, BRIAN PAUL (PT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PAUL
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 BUNCOMBE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-1905
Mailing Address - Country:US
Mailing Address - Phone:864-322-1025
Mailing Address - Fax:866-231-9826
Practice Address - Street 1:515 BUNCOMBE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-1905
Practice Address - Country:US
Practice Address - Phone:864-322-1025
Practice Address - Fax:866-231-9826
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3823208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH0947Medicaid
SCTH0947Medicaid