Lookup NPI Numbers from the NPI Registry
NPI Profile for MIKE KNICKERBOCKER in WARREN, AR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI Number | 1770847485 |
|
| Status | Active | |
| Credentials | LADAC | |
| Entity | Individual | |
| Enumeration date | 06/27/2012 | |
| Last updated | 06/27/2012 - About 14 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MIKE KNICKERBOCKER
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MIKE KNICKERBOCKER, LADAC