Individual
JOHN PAUL KNOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC
Contact information
Practice address
9330 W LINCOLN AVE STE 21, WEST ALLIS, WI 53227-2300
(414) 546-6880
(414) 546-6234
Mailing address
1591 S MOORLAND RD APT 101, NEW BERLIN, WI 53151-1585
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15344-131
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39177100
—
WI
Enumeration date
06/06/2007
Last updated
07/08/2007
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