Individual
CARRIE KNICKERBOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 W MAIN ST, INDEPENDENCE, KS 67301-3511
(620) 331-0999
(620) 331-1065
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(726) 202-3039
(210) 978-5592
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-04356
KS
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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