Provider Demographics
NPI:1205154242
Name:KNIGHT, ROBERT C (LMT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:REEDS SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:65737-0222
Mailing Address - Country:US
Mailing Address - Phone:417-272-8288
Mailing Address - Fax:
Practice Address - Street 1:16282 STATE HIGHWAY 13
Practice Address - Street 2:SUITE F
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737-8863
Practice Address - Country:US
Practice Address - Phone:417-272-8288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-15
Last Update Date:2010-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004018311225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist