Provider Demographics
NPI:1043224447
Name:KENTRIS, WILLIAM A (DC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:KENTRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 FOXFIRE LN
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:419-581-2094
Mailing Address - Fax:
Practice Address - Street 1:655 FOX RUN RD
Practice Address - Street 2:STE N
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-423-2268
Practice Address - Fax:419-423-2088
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1451111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0748589Medicaid
OH0748589Medicaid
T82005Medicare UPIN