Organization
ELITE SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY D KINEMOND (MEMBER)
(740) 266-4908
Entity
Organization
Contact information
Practice address
110 MAIN ST, WINTERSVILLE, OH 43953-3734
(740) 266-4908
(740) 264-4376
Mailing address
2315 SUNSET BLVD, SUITE F, STEUBENVILLE, OH 43952-2496
(740) 266-4908
(740) 264-4376
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3007749
—
OH
Enumeration date
11/18/2008
Last updated
09/20/2010
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