Basic Information
Provider Information
NPI: 1760590350
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNEIFL
FirstName: LISA
MiddleName: A.
NamePrefix: MS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2501 W 22ND ST
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571051305
CountryCode: US
TelephoneNumber: 6053363230
FaxNumber: 6053336878
Practice Location
Address1: 2501 W 22ND ST
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571051305
CountryCode: US
TelephoneNumber: 6053363230
FaxNumber: 6053336878
Other Information
ProviderEnumerationDate: 08/25/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X0232SDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home