Provider Demographics
NPI:1518989649
Name:KNAAK, ALLAN JAMES (REGISTERED PHARMACIS)
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:JAMES
Last Name:KNAAK
Suffix:
Gender:M
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4008
Mailing Address - Country:US
Mailing Address - Phone:734-994-9348
Mailing Address - Fax:734-668-9218
Practice Address - Street 1:325 N MAPLE RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2824
Practice Address - Country:US
Practice Address - Phone:734-668-9600
Practice Address - Fax:734-668-9218
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist