Individual
ETHAN KNISLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
500 SUMMER ST STE 406, STAMFORD, CT 06901-1397
(203) 355-2225
Mailing address
57 KENMARE ST APT 23, NEW YORK, NY 10012-4670
(614) 557-8604
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2213
CT
Other
Enumeration date
01/17/2021
Last updated
01/17/2021
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