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General NPI Number Information
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NPI Number | 1891791638
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Entity Type | Individual
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Provider Name | RANDALL KERTZ D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 9000 W THUNDERBIRD RD STE 205
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City | PEORIA
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State | AZ
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Zip | 85381-4451
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Country | US
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Telephone | 602-325-2024
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Fax | 720-925-5897
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Provider Business Mailing Address
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Address Line | 5445 DTC PKWY STE 1130
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3038
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Country | US
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Telephone | 720-749-5599
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Fax | 720-925-5897
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038008990
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9084
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License Number State | AZ
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