# KETTMAN PRANGER FAMILY MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902124175
- **Authorized official:** MATTHEW J KETTMAN M.D. (OWNER)
- **Authorized official phone:** (319) 236-7720

## Contact information

- **Practice address:** 220 SOUTHBROOKE DR, WATERLOO, IA 50702-5802
- **Practice address phone:** (319) 236-7720
- **Practice address fax:** (319) 236-7739
- **Mailing address:** PO BOX 658, WATERLOO, IA 50704-0658
- **Mailing address phone:** (319) 236-7720
- **Mailing address fax:** (319) 236-7739

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 33683 | IA | Yes |

## Other

- **Enumeration date:** 05/12/2010
- **Last updated:** 08/13/2012