Glenn J. Kietzer MD

NPI 1003847179 - General Practice - 208D00000X

NPI Details
NPI 1003847179
Gender Male
Enumeration Date 07/06/2006
Last Updated 05/07/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
15005 PACIFIC AVE
SPANAWAY GENERAL MEDICAL
TACOMA WA, 98444, US
Phone (253) 537-3724
Fax (253) 537-6425
Business Location
15005 PACIFIC AVE
SPANAWAY GENERAL MEDICAL
TACOMA WA, 98444, US
Phone (253) 537-3724
Fax (253) 537-6425
Toxanomy
Taxonomy Code 208D00000X
License State Washington
License Number MD00009584
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According to our database, Dr. Glenn J. Kietzer MD NPI is 1003847179, taxonomy code is 208D00000X and license number is MD00009584, license state is located at Washington. Glenn J. Kietzer MD physically located at 15005 Pacific Ave, Tacoma WA, 98444. NPI Number Glenn J. Kietzer MD has the Individual type.

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1003847179 NPI number is provided on an as is basis without warranty of any kind. 1003847179 is maintained by the National Plan & Provider Enumeration System. The contents of Glenn J. Kietzer MD are for informational purposes only.