Provider Demographics
NPI:1447229505
Name:KINTNER, MARY HELEN (DC, RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:HELEN
Last Name:KINTNER
Suffix:
Gender:F
Credentials:DC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 VERMONT ROUTE 15
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-2044
Mailing Address - Country:US
Mailing Address - Phone:802-899-5400
Mailing Address - Fax:802-899-5497
Practice Address - Street 1:397 VERMONT ROUTE 15
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:VT
Practice Address - Zip Code:05465-2044
Practice Address - Country:US
Practice Address - Phone:802-899-5400
Practice Address - Fax:802-899-5497
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000834111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT9924OtherBCBS
VTVT00834OtherLANDMARK
VT98L091OtherMVP
VT42827OtherCIGNA
VT42827OtherCIGNA
VTVT9428Medicare PIN