Individual
HOLLY JO KNUCKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
613 23RD ST STE 520, ASHLAND, KY 41101-2878
(606) 326-1674
(606) 326-1436
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA987
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111905
—
OH
05
—
7100344510
—
KY
Enumeration date
02/23/2007
Last updated
01/19/2024
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