Individual
DR. BRUCE CARL KNICKELBEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
9 N 7TH ST, SUITE 203, INDIANA, PA 15701-1880
(724) 357-7196
(724) 357-7279
Mailing address
1265 WAYNE AVE, SUITE 201, INDIANA, PA 15701-3501
(724) 349-3290
(724) 349-3786
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002328L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017211930002
—
PA
Enumeration date
09/29/2006
Last updated
01/15/2013
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