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Individual

GRACE WETTENGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1630 E HERNDON AVE, FRESNO, CA 93720-3391
(402) 630-6316
Mailing address
101 WOODCLIFF CIR, COUNCIL BLUFFS, IA 51503-4288
(402) 630-6316

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
09/27/2021
Last updated
01/05/2023
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