Provider Demographics
NPI:1720336340
Name:KNAPP, CONNOR J (DPT)
Entity Type:Individual
Prefix:
First Name:CONNOR
Middle Name:J
Last Name:KNAPP
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 SULLIVAN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3147
Mailing Address - Country:US
Mailing Address - Phone:256-325-2130
Mailing Address - Fax:256-325-2142
Practice Address - Street 1:3825 SULLIVAN ST STE 2
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3147
Practice Address - Country:US
Practice Address - Phone:256-325-2130
Practice Address - Fax:256-325-2142
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK490225100000X
2251S0007X
ALPTH67692251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic