Provider Demographics
NPI:1093794992
Name:KUNZ, JONATHON (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:
Last Name:KUNZ
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 1:1719 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2007
Mailing Address - Country:US
Mailing Address - Phone:605-929-5650
Mailing Address - Fax:
Practice Address - Street 1:3628 S SOUTHEASTERN AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-7123
Practice Address - Country:US
Practice Address - Phone:605-271-5550
Practice Address - Fax:605-271-5551
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD2352679OtherAMERICA'S PPO
SD7377685OtherAETNA
SD7602000Medicaid
SD10248OtherAVERA HEALTH PLANS
SDC1050OtherDAKOTACARE
SD7377685OtherPRONET
SD670122OtherACN NETWORK ID NUMBER
SD40765OtherSIOUX VALLEY HEALTH PLAN
SD4995007OtherWELLMARK BCBS
SD7377685OtherPRONET