Provider Demographics
NPI:1740823822
Name:KNIEFF, JORDAN THERON (ND)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:THERON
Last Name:KNIEFF
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14414 STEWART LN APT 414
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-5876
Mailing Address - Country:US
Mailing Address - Phone:320-630-0352
Mailing Address - Fax:
Practice Address - Street 1:14525 HIGHWAY 7 STE 375
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3741
Practice Address - Country:US
Practice Address - Phone:320-348-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1107175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath