Individual
KENNETH LOUIS KOONTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
322 FOREST HILL AVE, WINSTON SALEM, NC 27105-3518
(743) 333-1799
Mailing address
322 FOREST HILL AVE, WINSTON SALEM, NC 27105-3518
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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