Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 2601000910 | MI |
Y | 213ES0000X | Sports Medicine | 2601000910 | MI |
NPI | 1265871511 |
---|---|
Provider Name | Brett Knight |
First Address | Elwell, MI 48832-9708 |
Second Address | Alma, MI 48801-1504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2013 |
Last Update Date | 20/06/2013 |