Provider Demographics
NPI:1033626874
Name:KUNZE, RUSTY
Entity Type:Individual
Prefix:
First Name:RUSTY
Middle Name:
Last Name:KUNZE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-2621
Mailing Address - Country:US
Mailing Address - Phone:330-784-8480
Mailing Address - Fax:330-784-8044
Practice Address - Street 1:766 CANTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-2621
Practice Address - Country:US
Practice Address - Phone:330-784-8480
Practice Address - Fax:330-784-8044
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3089237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist