Provider Demographics
NPI:1659316479
Name:HINTZ, MARILYN JOAN (MS, ATC/L, CSCS)
Entity Type:Individual
Prefix:MISS
First Name:MARILYN
Middle Name:JOAN
Last Name:HINTZ
Suffix:
Gender:F
Credentials:MS, ATC/L, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4831 E PINCHOT AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-6507
Mailing Address - Country:US
Mailing Address - Phone:414-704-4473
Mailing Address - Fax:
Practice Address - Street 1:15410 S MOUNTAIN PKWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6691
Practice Address - Country:US
Practice Address - Phone:480-940-8299
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer