Individual
JACOB KINTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
623 E MONTCLAIR ST, APT 3B, SPRINGFIELD, MO 65807-8932
(417) 865-2815
Mailing address
623 E MONTCLAIR ST, APT 3B, SPRINGFIELD, MO 65807-8932
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2016028027
MO
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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