Provider Demographics
NPI:1922838549
Name:KNAPTON, JACOB (DC)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:KNAPTON
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 1:559 W STATE RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2111
Mailing Address - Country:US
Mailing Address - Phone:801-922-4310
Mailing Address - Fax:801-471-2777
Practice Address - Street 1:559 W STATE RD
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2111
Practice Address - Country:US
Practice Address - Phone:801-922-4310
Practice Address - Fax:801-471-2777
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT100000000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty