Provider Demographics
NPI:1205848470
Name:KUNZ, FERRIS M (RPH)
Entity type:Individual
Prefix:MR
First Name:FERRIS
Middle Name:M
Last Name:KUNZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 W 1115 N
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:UT
Mailing Address - Zip Code:84015-3608
Mailing Address - Country:US
Mailing Address - Phone:801-773-8171
Mailing Address - Fax:
Practice Address - Street 1:26 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-1817
Practice Address - Country:US
Practice Address - Phone:801-693-7950
Practice Address - Fax:801-693-7955
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT140242-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist