Provider Demographics
NPI:1700520004
Name:KNAPP, DEBRA DARNICE (LMT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:DARNICE
Last Name:KNAPP
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 BRIARWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6341
Mailing Address - Country:US
Mailing Address - Phone:386-627-5366
Mailing Address - Fax:
Practice Address - Street 1:2424 DANVILLE RD SW STE O
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-4219
Practice Address - Country:US
Practice Address - Phone:386-627-5366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5931225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist