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General NPI Number Information
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NPI Number | 1790778918
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Entity Type | Individual
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Provider Name | CRAIG L KUNTZ O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 270 S CANDY LN
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4164
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Country | US
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Telephone | 928-634-4202
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Fax | 928-634-5963
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Provider Business Mailing Address
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Address Line | 2610 E UNIVERSITY DR
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City | MESA
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State | AZ
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Zip | 85213-8436
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Country | US
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Telephone | 480-892-8400
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Fax | 480-892-1889
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 337
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1885
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License Number State | AZ
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