Individual
TANYA MARIE KNOUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
8475 W MOUND RD, LENA, IL 61048-9016
(815) 238-8908
Mailing address
8475 W MOUND RD, LENA, IL 61048-9016
(815) 238-8908
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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