| Organization Name: | DANIEL S KANTZ PSC |
| NPI Number: | 1912961012 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL S KANTZ (DO OWNER) |
| Mailing Address: | 2100 Market St #106 Charlestown |
| State: | IN US |
| Postal Code: | 47111 |
| Phone Number: | 8122567830 |
| Fax Number: | 8122567835 |
| NPI Enumeration Date: | 04/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 02002542A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |