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NPI Code Detail

MEDICARE: JOSHUA WINTZ

MEDICARE: JOSHUA WINTZ
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
12255A2300XAthletic TrainerMN

General Provider Information

NPI Number : 1982195558
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA WINTZ
Provider Business Mailing Address
First Line : 4112 MORRILL LN
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-3656
Country : US
Telephone Number : 612-298-3177
Fax Number :
Provider Business Practice Location Address
First Line : 4112 MORRILL LN
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-3656
Country : US
Telephone Number : 612-298-3177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2018
Last Update Date : 05/19/2018

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Directions to “ JOSHUA WINTZ ” Practice Location

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