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Individual

KELLY JO GITTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC

Contact information

Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
(920) 496-4705
Mailing address
PO BOX 19070, PREVEA HEALTH, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 496-4705

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
142
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41115300
WI
Enumeration date
07/13/2006
Last updated
07/08/2007
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