Individual
DR. MATTHEW CHARLES KNOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, BCPS, BCNSP
Contact information
Practice address
500 N HWY 89, PRESCOTT VA FACILITY, PRESCOTT, AZ 86313
(765) 491-6859
Mailing address
500 N HWY 89, PHARMACY DEPARTMENT, PRESCOTT, AZ 86313
(765) 491-6859
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
26023176A
IN
1835N1003X
Nutrition Support Pharmacist
26023176A
IN
1835P1200X
Pharmacotherapy Pharmacist
26023176A
IN
1835P2201X
Ambulatory Care Pharmacist
Primary
26023176A
IN
Other
Enumeration date
07/27/2015
Last updated
03/01/2022
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