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1376937011
TYLER HEINTZELMAN
LEAVENWORTH, KS
NPI
1376937011
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2015-03-19
Last Update Date
2015-03-19
Business Address
TYLER HEINTZELMAN
2089 LIMIT ST
LEAVENWORTH, KS 66048-4063
Phone number: 913-596-0162
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Mailing Address
TYLER HEINTZELMAN
2089 LIMIT ST
LEAVENWORTH, KS 66048-4063
Phone number: 913-596-0162
Copy
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