Individual
JASON WILLIAM KNICLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3540 SUGARLOAF PKWY STE D03, FREDERICK, MD 21704-7901
(240) 341-2198
(240) 454-8423
Mailing address
10938 LOUIS DETRICK LN, MONROVIA, MD 21770-6030
(301) 992-6797
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23476
MD
Other
Enumeration date
11/03/2010
Last updated
07/12/2021
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