Provider Demographics
NPI:1285024901
Name:KARTZINEL WELLNESS CENTER 2 PA
Entity Type:Organization
Organization Name:KARTZINEL WELLNESS CENTER 2 PA
Other - Org Name:KARTZINEL WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KARTZINEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-398-7654
Mailing Address - Street 1:174 MURRAY GUARD DR STE C
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3742
Mailing Address - Country:US
Mailing Address - Phone:949-398-7654
Mailing Address - Fax:949-407-6788
Practice Address - Street 1:174 MURRAY GUARD DR STE C
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3742
Practice Address - Country:US
Practice Address - Phone:949-398-7654
Practice Address - Fax:949-407-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental DisabilitiesGroup - Single Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty