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Individual
JENNIFER S KOONTZ
Active
Individual
JENNIFER S KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
04-32109
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200409950A
—
KS
Enumeration date
11/09/2006
Last updated
05/09/2014
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