Provider Demographics
NPI:1699404467
Name:KUNTZ, ZACHARY WILLIAM
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:WILLIAM
Last Name:KUNTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 PAVEMENT RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-9519
Mailing Address - Country:US
Mailing Address - Phone:716-352-7050
Mailing Address - Fax:
Practice Address - Street 1:4613 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2594
Practice Address - Country:US
Practice Address - Phone:703-751-1052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist