Healthcare Provider Details

I. General information

NPI: 1558425959
Provider Name (Legal Business Name): HENRY N KUNTZ D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CONGRESS PARK DR
DAYTON OH
45459-4099
US

IV. Provider business mailing address

PO BOX 750668
DAYTON OH
45475-0668
US

V. Phone/Fax

Practice location:
  • Phone: 937-439-9330
  • Fax: 937-439-9337
Mailing address:
  • Phone: 937-439-9330
  • Fax: 937-439-9337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberC53991
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2548
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC2548
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: