Provider Demographics
NPI:1609395508
Name:KNECHT, KELCEY BROOKE (MS, ATC)
Entity type:Individual
Prefix:MRS
First Name:KELCEY
Middle Name:BROOKE
Last Name:KNECHT
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:KELCEY
Other - Middle Name:BROOKE
Other - Last Name:ATCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 MCMURRY UNIVERSITY BOX 248
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79697-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MCMURRY UNIVERSITY
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79697-0001
Practice Address - Country:US
Practice Address - Phone:216-798-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0047042255A2300X
TX2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer