Individual
MR. JONATHON LOVERCAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
245 NE 30 RD, GREAT BEND, KS 67530-9251
(620) 786-1149
Mailing address
2600 ADAMS ST APT 8, GREAT BEND, KS 67530-7167
(417) 682-1737
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-01084
KS
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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