Jack McIntyre Kimmell
Jack McIntyre Kimmell is an Athletic Trainer in South Bend, Indiana. Licensed in Indiana. Registered with an NPI since 2016.
- Licensed in
- IN
- In the registry since
- 2016
- Specialties on file
- 2
Practice location Address checks out
1526 E LasalleSouth Bend, IN 46617
Phone: (574) 310-1911
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X · Licence 3925375607 (IN) |
|---|---|
| Athletic Trainer | Taxonomy 2255A2300X · Licence 3925375607 (IN) |
Record details
| NPI number | 1740731116 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | October 20, 2016 |
| Last updated in NPPES | October 20, 2016 |
| Mailing address | 1526 E Lasalle Ave, South Bend, IN 46617-2606 |
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