Healthcare Provider Details

I. General information

NPI: 1427090604
Provider Name (Legal Business Name): JONATHON KUNZ, DC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 S SOUTHEASTERN AVE
SIOUX FALLS SD
57103
US

IV. Provider business mailing address

3630 S SOUTHEASTERN AVE
SIOUX FALLS SD
57103
US

V. Phone/Fax

Practice location:
  • Phone: 605-271-5550
  • Fax: 605-271-5551
Mailing address:
  • Phone: 605-271-5550
  • Fax: 605-271-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1050
License Number StateSD

VIII. Authorized Official

Name: DR. JONATHON KUNZ
Title or Position: PRESIDENT
Credential: D.C.
Phone: 605-271-5550