Provider Demographics
NPI:1154577708
Name:KRANZ, MICHAEL (PT,OT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:KRANZ
Suffix:
Gender:M
Credentials:PT,OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 WINDY HILL RD SE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8665
Mailing Address - Country:US
Mailing Address - Phone:770-850-8464
Mailing Address - Fax:770-850-9727
Practice Address - Street 1:3 BOULDER ROCK DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8555
Practice Address - Country:US
Practice Address - Phone:386-445-9444
Practice Address - Fax:386-446-2971
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-016628225100000X
IL056-008419225X00000X
FLPT26570225100000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist