Provider Demographics
NPI:1932446523
Name:KNAGGS, CORY M (LMT)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:M
Last Name:KNAGGS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 S BYRNE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-1005
Mailing Address - Country:US
Mailing Address - Phone:419-382-7400
Mailing Address - Fax:
Practice Address - Street 1:743 S BYRNE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-1005
Practice Address - Country:US
Practice Address - Phone:419-382-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33. 019092 H-K225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH$$$$$$$$$-00OtherBUREAU OF WORKER'S COMPENSATION