Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 51782432401 | UT |
NPI | 1194873596 |
---|---|
Provider Name | Dr. Jonathan Herbert Kinzinger |
First Address | Salt Lake City, UT 84151-0721 |
Second Address | Salt Lake City, UT 84132-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 25/01/2022 |