Individual
COLIN BRENNAN KNIPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
560 W MITCHELL ST STE 125, PETOSKEY, MI 49770-2276
(231) 487-3182
Mailing address
560 W MITCHELL ST STE 125, PETOSKEY, MI 49770-2276
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601008974
STATE OF MICHIGAN LICENSE
MI
Enumeration date
12/11/2019
Last updated
12/11/2019
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