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Individual
THERESA ANN KNOLL
Active
Individual
THERESA ANN KNOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070017118
IL
225100000X
Physical Therapist
8149
TN
225100000X
Physical Therapist
Primary
PT60736405
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10115176
BCBS GRP #
IL
01
—
769380
MEDICARE GROUP PTAN
IL
Enumeration date
12/16/2008
Last updated
10/09/2017
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