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Brandon Knickerbocker
NPI 1235873399 · on the registry since 2022 · sole proprietor
Practice
- Address
- 6296 Village Square Drive
Suite 2
Bridgeport, MI 48722 - Phone
- (989) 401-1239
- Clinicians at this address
- 27
Additional practice sites
- 5039 Villa Linde Parkway, Bridgeport, MI
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-04-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan