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General NPI Number Information
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NPI Number | 1164428496
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Entity Type | Individual
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Provider Name | GINA LOUISE KONTZ M.A.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 408 N 1ST ST STE 2
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City | MONTEVIDEO
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State | MN
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Zip | 56265
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Country | US
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Telephone | 320-321-1551
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Fax | 320-321-1552
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Provider Business Mailing Address
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Address Line | 408 N 1ST ST STE 2
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City | MONTEVIDEO
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State | MN
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Zip | 56265-4551
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Country | US
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Telephone | 320-321-1551
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Fax | 320-321-1552
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 6279
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License Number State | MN
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