Individual
JACK L HULSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 MAIN ST APT 106, KANSAS CITY, MO 64105-1280
(417) 379-2689
Mailing address
200 MAIN ST APT 106, KANSAS CITY, MO 64105-1280
(417) 379-2689
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/10/2026
Last updated
01/10/2026
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