Individual
JASON KOFOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA ATC
Contact information
Practice address
1201 10TH AVE, GRINNELL, IA 50112-1200
(641) 269-3808
Mailing address
1201 10TH AVE, GRINNELL, IA 50112-1200
(641) 269-9744
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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