Provider Demographics
NPI:1457164246
Name:KNOCH, CARRIE L (MED)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:KNOCH
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-1959
Mailing Address - Country:US
Mailing Address - Phone:419-234-3690
Mailing Address - Fax:
Practice Address - Street 1:306 W PEARL ST
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-1959
Practice Address - Country:US
Practice Address - Phone:419-234-3690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care