Individual
JONATHAN HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1913 WILLOW BEND DR, RED OAK, TX 75154-3871
(214) 815-7006
Mailing address
1913 WILLOW BEND DR, RED OAK, TX 75154-3871
(214) 815-7006
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
TX
2255A2300X
Athletic Trainer
Primary
—
TX
Other
Enumeration date
09/27/2021
Last updated
10/05/2021
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