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NPI Code Detail

MEDICARE: JENNA KINZER

MEDICARE: JENNA KINZER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist30792AZ

General Provider Information

NPI Number : 1578119491
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA KINZER
Provider Business Mailing Address
First Line : 17830 N 45TH AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-1650
Country : US
Telephone Number : 719-235-6566
Fax Number :
Provider Business Practice Location Address
First Line : 2655 W CAREFREE HWY
Second Line :
City : PHOENIX
State : AZ
Zip : 85085-8862
Country : US
Telephone Number : 623-434-4655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2019
Last Update Date : 08/15/2019

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Directions to “ JENNA KINZER ” Practice Location

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