Provider Demographics
NPI:1942237904
Name:KNAPP, TONY A (DC)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:A
Last Name:KNAPP
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 1:46859 HARRY BYRD HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-2253
Mailing Address - Country:US
Mailing Address - Phone:703-406-8686
Mailing Address - Fax:
Practice Address - Street 1:46859 HARRY BYRD HWY
Practice Address - Street 2:STE 102
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-2253
Practice Address - Country:US
Practice Address - Phone:703-406-8686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00438111N00000X
VA0104556607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIU83956Medicare UPIN
RI359022186Medicare ID - Type Unspecified
VASC0001006Medicare PIN