Basic Information
| Provider Information | |||||||||
| NPI: | 1669871521 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNIGHT | ||||||||
| FirstName: | STEPHEN | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 112 MAPLE DR | ||||||||
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| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214033926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8022792180 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4968 MOUNTAIN RD | ||||||||
| Address2: | |||||||||
| City: | STOWE | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056725349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8022535694 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2014 | ||||||||
| LastUpdateDate: | 06/26/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 0400002988 | VT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.