Basic Information
| Provider Information | |||||||||
| NPI: | 1679790034 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNAPIK | ||||||||
| FirstName: | THERSIA | ||||||||
| MiddleName: | JEANE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 15TH ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806314563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708108216 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1800 15TH ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806314563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199668076 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2007 | ||||||||
| LastUpdateDate: | 07/16/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2086S0127X | CDR.0000434 | CO | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
No ID Information.