Individual
MARK JOSEPH KNOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6000
(440) 922-0145
Mailing address
5410 MARYLAND WAY STE 300, BRENTWOOD, TN 37027-5339
(615) 377-5603
(615) 290-5191
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2012035227
MO
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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