Provider Demographics
NPI:1144432865
Name:KUNZE, MELANIE ANN (MS, ATC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ANN
Last Name:KUNZE
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21730 STAR LITE DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:OH
Mailing Address - Zip Code:43845-9004
Mailing Address - Country:US
Mailing Address - Phone:740-545-0716
Mailing Address - Fax:
Practice Address - Street 1:26496 STATE ROUTE 60
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:OH
Practice Address - Zip Code:43844-9714
Practice Address - Country:US
Practice Address - Phone:740-824-3522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT - 0008582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer