Individual
DR. KYLE EDWIN GANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1405 S DETROIT ST, BELLEFONTAINE, OH 43311-9709
(937) 592-6321
(937) 592-7644
Mailing address
645 EASTERN AVE, BELLEFONTAINE, OH 43311-2613
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3540
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2552821
—
OH
Enumeration date
01/11/2007
Last updated
07/08/2007
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