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Individual

J. DOUGLAS KURTZ JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
5000 MARILAKE CIR, KETTERING, OH 45429-5416
(937) 291-3331
Mailing address
5000 MARILAKE CIR, KETTERING, OH 45429-5416
(937) 291-3331

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN110896
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2671934
OH
Enumeration date
03/22/2007
Last updated
07/09/2007
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