Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 0420010039 | VT |
NPI | 1003849191 |
---|---|
Provider Name | Dr. Roger Chaloner Knakal |
First Address | Colchester, VT 05446-3007 |
Second Address | Colchester, VT 05446-3007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F86887 | (02) | VT |