Provider Demographics
NPI:1225744915
Name:KUNKLER, CHELSEY MARIE (OD)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:MARIE
Last Name:KUNKLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45869-1342
Mailing Address - Country:US
Mailing Address - Phone:567-644-5003
Mailing Address - Fax:
Practice Address - Street 1:570 E KREMER HOYING RD
Practice Address - Street 2:
Practice Address - City:SAINT HENRY
Practice Address - State:OH
Practice Address - Zip Code:45883-7600
Practice Address - Country:US
Practice Address - Phone:419-678-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.007135152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist