Provider Demographics
NPI:1558425959
Name:KUNTZ, HENRY N (DC)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:N
Last Name:KUNTZ
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:PO BOX 750668
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45475-0668
Mailing Address - Country:US
Mailing Address - Phone:937-439-9330
Mailing Address - Fax:937-439-9337
Practice Address - Street 1:925 CONGRESS PARK DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4099
Practice Address - Country:US
Practice Address - Phone:937-439-9330
Practice Address - Fax:937-439-9337
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC53991225000000X
OH2548111N00000X
OHDC2548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2650144Medicaid
U69482Medicare UPIN