Provider Demographics
NPI:1760662159
Name:WILLIAM A. KENTRIS, D.C. INC
Entity Type:Organization
Organization Name:WILLIAM A. KENTRIS, D.C. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENTRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-423-2268
Mailing Address - Street 1:1665 TIFFIN AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6853
Mailing Address - Country:US
Mailing Address - Phone:419-423-2268
Mailing Address - Fax:419-423-2088
Practice Address - Street 1:1665 TIFFIN AVE
Practice Address - Street 2:SUITE F
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6853
Practice Address - Country:US
Practice Address - Phone:419-423-2268
Practice Address - Fax:419-423-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1451111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0921248Medicaid
OH0921248Medicaid