Provider Demographics
NPI:1174618029
Name:KNAPP, JODY LEE (DC)
Entity type:Individual
Prefix:MR
First Name:JODY
Middle Name:LEE
Last Name:KNAPP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:DORSET
Mailing Address - State:VT
Mailing Address - Zip Code:05251-0247
Mailing Address - Country:US
Mailing Address - Phone:802-645-9244
Mailing Address - Fax:802-645-9243
Practice Address - Street 1:87 MEADOW LN
Practice Address - Street 2:
Practice Address - City:DORSET
Practice Address - State:VT
Practice Address - Zip Code:05251-9463
Practice Address - Country:US
Practice Address - Phone:802-645-9244
Practice Address - Fax:802-645-9243
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010508111N00000X
VT0060001103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1022017Medicaid
VT58567OtherBCBS
VT1022017Medicaid
NY0060001103OtherLANDMARK
NY0060001103OtherLANDMARK