Provider Demographics
NPI:1871898940
Name:KNAPP, GLENNA J (ATC;PNMT;EMT)
Entity type:Individual
Prefix:
First Name:GLENNA
Middle Name:J
Last Name:KNAPP
Suffix:
Gender:F
Credentials:ATC;PNMT;EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 STRATFORD CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8239
Mailing Address - Country:US
Mailing Address - Phone:513-543-2358
Mailing Address - Fax:
Practice Address - Street 1:500 E BUSINESS WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2374
Practice Address - Country:US
Practice Address - Phone:513-543-2358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT-1020172M00000X
OH33-009195172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist