Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | CO | |
N | 225700000X | Massage Therapist | CO | |
N | 225X00000X | Occupational Therapist | CO | |
N | 225XH1200X | Occupational Therapist - Hand | CO |
NPI | 1649575184 |
---|---|
Provider Name | Mrs. Jennifer Ann Knox |
First Address | Longmont, CO 80501 |
Second Address | Longmont, CO 80501-6972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2011 |
Last Update Date | 13/01/2011 |