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General NPI Number Information
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NPI Number | 1093381352
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Entity Type | Individual
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Provider Name | JACQUELINE RENEE WINTER DPT, ATC
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Gender | Female
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 8250 N CHURCH RD STE B
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City | KANSAS CITY
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State | MO
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Zip | 64158-1103
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Country | US
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Telephone | 816-503-8371
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Fax |
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Provider Business Mailing Address
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Address Line | 407 NW 15P RD
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City | CLINTON
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State | MO
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Zip | 64735-9246
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Country | US
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Telephone | 660-492-3428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | MO
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