Healthcare Provider Details

I. General information

NPI: 1346861036
Provider Name (Legal Business Name): SETH KUNKLE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 VIP DR STE 105
WEXFORD PA
15090-6928
US

IV. Provider business mailing address

205 GLENDALE AVE
BUTLER PA
16001-3530
US

V. Phone/Fax

Practice location:
  • Phone: 724-305-8135
  • Fax: 724-772-5564
Mailing address:
  • Phone: 724-822-1608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC012006
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberTSMG000956
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: