Provider Demographics
NPI:1760533855
Name:KUNZ, STEVEN J (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
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 1:117 FAREWELL AVE # A
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3623
Mailing Address - Country:US
Mailing Address - Phone:907-457-2588
Mailing Address - Fax:
Practice Address - Street 1:117 FAREWELL AVE # A
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3623
Practice Address - Country:US
Practice Address - Phone:907-457-2588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKT75577Medicare UPIN