Provider Demographics
NPI:1801960745
Name:KNECHTEL, DANIEL DAMON (DO)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:DAMON
Last Name:KNECHTEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MONT CLAIR DR
Mailing Address - Street 2:
Mailing Address - City:NORTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-3382
Mailing Address - Country:US
Mailing Address - Phone:801-294-2332
Mailing Address - Fax:
Practice Address - Street 1:395 N 200 W
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-7045
Practice Address - Country:US
Practice Address - Phone:801-295-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor