Provider Demographics
NPI:1699325456
Name:KNIGHT, HAYDEN ALAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:ALAN
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 FOUNTAINBLEAU RD
Mailing Address - Street 2:
Mailing Address - City:KEITHVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71047-6552
Mailing Address - Country:US
Mailing Address - Phone:318-465-2806
Mailing Address - Fax:
Practice Address - Street 1:854 HURST ST STE 108
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-3440
Practice Address - Country:US
Practice Address - Phone:936-598-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10518R225100000X
TX3124697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist