Penelope Lois Knochel

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Palmyra, MO

NPI 1487778486 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487778486
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Practice address
7121 County Road 336
Palmyra, MO 63461-2221
Phone
(573) 769-2845
NPI assigned
Mar 17, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

7121 County Road 336
Palmyra, MO 63461-2221

Mailing address

7121 County Road 336
Palmyra, MO 63461-2221
Phone (573) 769-2845

Other providers in Palmyra, MO

All providers in Palmyra, MO · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri

Sources for this page

Verify at the official NPI Registry.