Provider Demographics
NPI:1144771858
Name:SUNTKEN, KEVIN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DAVID
Last Name:SUNTKEN
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 1:140 8TH ST SE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-1950
Mailing Address - Country:US
Mailing Address - Phone:515-957-9700
Mailing Address - Fax:515-957-9513
Practice Address - Street 1:140 8TH ST SE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1950
Practice Address - Country:US
Practice Address - Phone:515-957-9700
Practice Address - Fax:515-957-9513
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA084443111N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program