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NPI Code Detail

MEDICARE: PAULINE L KUNTZ SLP

MEDICARE:   PAULINE L KUNTZ  SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist000368GA

General Provider Information

NPI Number : 1538163167
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULINE L KUNTZ SLP
Provider Business Mailing Address
First Line : 2160 SMYRNA RIDGE CT SW
Second Line :
City : CONYERS
State : GA
Zip : 30094-6200
Country : US
Telephone Number : 770-483-1083
Fax Number : 770-483-1083
Provider Business Practice Location Address
First Line : 2160 SMYRNA RIDGE CT SW
Second Line :
City : CONYERS
State : GA
Zip : 30094-6200
Country : US
Telephone Number : 770-483-1083
Fax Number : 770-483-1083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 07/09/2007

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Directions to “ PAULINE L KUNTZ SLP” Practice Location

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