Provider Demographics
NPI:1962123448
Name:KUNZ, RONALD
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:KUNZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 36TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW SALEM
Mailing Address - State:ND
Mailing Address - Zip Code:58563-9013
Mailing Address - Country:US
Mailing Address - Phone:701-226-2059
Mailing Address - Fax:
Practice Address - Street 1:4425 36TH ST
Practice Address - Street 2:
Practice Address - City:NEW SALEM
Practice Address - State:ND
Practice Address - Zip Code:58563-9013
Practice Address - Country:US
Practice Address - Phone:701-226-2059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant