Individual
MR. KENNETH IVAN HARTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
250 SMITH CHURCH RD, ROANOKE RAPIDS, NC 27870-4914
(252) 535-8185
Mailing address
308 ROLLINGWOOD RD, ROANOKE RAPIDS, NC 27870-3249
(252) 533-0580
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
121072
NC
Other
Enumeration date
02/19/2007
Last updated
07/08/2007
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