Most Relevant Information
Provider Data
| NPI Number: | 1003479775 |
| Provider Name: | KRISTIN LAURA KNIECH DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/18/2019 |
| Last Updated: | 08/16/2023 |
Provider Practice Location
3003 UNIVERSITY DR
MARINETTE
WI
541434110
Practice Location Phone/Fax
| Phone: | 7157354200 |
| Fax: |
Provider Mailing Location
PO BOX 735044
CHICAGO
IL
606735044
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |