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Individual

JACK MCKNIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
19712 POPLAR ST, BEND, OR 97702-9036
(951) 537-4424
(858) 279-5303
Mailing address
19712 POPLAR ST, BEND, OR 97702-9036
(951) 537-4424

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
62235
OR
225100000X
Physical Therapist
PT 43134
CA

Other

Enumeration date
09/29/2015
Last updated
03/27/2024
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