Provider Demographics
NPI:1013904101
Name:KRANTZ, ANDREW HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HENRY
Last Name:KRANTZ
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 1:3722 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-2621
Mailing Address - Country:US
Mailing Address - Phone:770-928-2663
Mailing Address - Fax:770-516-8583
Practice Address - Street 1:3722 CANTON RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-2621
Practice Address - Country:US
Practice Address - Phone:770-928-2663
Practice Address - Fax:770-516-8583
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA1440111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4339170OtherAETNA ID NUMBER
GA6593074OtherCIGNA ID NUMBER
GA52551271OtherBCBS ID NUMBER
GA6593074OtherCIGNA ID NUMBER