Individual
SHANNON KUETTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6320 W UNION HILLS DR STE A180, GLENDALE, AZ 85308-7153
(623) 748-8300
(623) 748-8314
Mailing address
4700 N 16TH ST APT 235, PHOENIX, AZ 85016-4662
(612) 325-2022
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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