Healthcare Provider Details

I. General information

NPI: 1326510249
Provider Name (Legal Business Name): KANTNER CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2018
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BREWFIELD DR
WAPAKONETA OH
45895-9394
US

IV. Provider business mailing address

801 BREWFIELD DR
WAPAKONETA OH
45895-9394
US

V. Phone/Fax

Practice location:
  • Phone: 419-738-4373
  • Fax: 419-738-3780
Mailing address:
  • Phone: 419-738-4373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD D. KANTNER
Title or Position: OWNER
Credential: DC
Phone: 419-738-4373