Individual
AMY B JENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 E WASHINGTON ST, IONIA, MI 48846-2202
(616) 523-1630
(616) 523-1631
Mailing address
550 E WASHINGTON ST, IONIA, MI 48846-2202
(616) 522-0714
(616) 522-0456
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
AJ076427
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03004
PRIORITY HEALTH PAY TO #
MI
01
—
1016881
MCLAREN
MI
05
—
104791262
—
MI
01
—
200000002169
PHPMM
MI
01
—
383218134
TRICARE
MI
01
—
4791262
MOLINA
MI
01
—
700C460060
BCBS OF MI GROUP
MI
Enumeration date
08/20/2006
Last updated
04/09/2010
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