Individual
JESSE KOGELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
550 MUNSON AVE, SUITE 200, TRAVERSE CITY, MI 49686-3580
(231) 935-8717
(231) 935-9230
Mailing address
550 MUNSON AVE, SUITE 200, TRAVERSE CITY, MI 49686-3580
(231) 935-8717
(231) 935-9230
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601006005
MI
Other
Enumeration date
09/22/2011
Last updated
10/02/2015
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