Individual provider · Type 1 NPI
Ethan Knisley, DC
Chiropractor · Stamford, CT
NPI number
1396334017
Active
Practice location
500 Summer St Ste 406
Stamford, CT 06901-1397
Mailing address
57 Kenmare St Apt 23
New York, NY 10012-4670
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 2213 (CT) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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About NPI 1396334017
Ethan Knisley, DC's National Provider Identifier is 1396334017, issued on Jan 17, 2021. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Stamford, CT. The record was last updated on Jan 17, 2021.