Provider Demographics
NPI:1396367066
Name:KUNZ, STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
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 1:19406 345TH ST
Mailing Address - Street 2:
Mailing Address - City:ERHARD
Mailing Address - State:MN
Mailing Address - Zip Code:56534-9573
Mailing Address - Country:US
Mailing Address - Phone:218-205-2767
Mailing Address - Fax:
Practice Address - Street 1:19406 345TH ST
Practice Address - Street 2:
Practice Address - City:ERHARD
Practice Address - State:MN
Practice Address - Zip Code:56534-9573
Practice Address - Country:US
Practice Address - Phone:218-205-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor