Organization
GREAT LAKES EAR NOSE & THROAT SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L GIETZEN DO (DOCTOR)
(231) 838-1571
Entity
Organization
Contact information
Practice address
1114 CHARLEVOIX AVE, PETOSKEY, MI 49770-9701
(231) 489-8151
(231) 668-7794
Mailing address
1114 CHARLEVOIX AVE, PETOSKEY, MI 49770-9701
(231) 489-8151
(231) 668-7794
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
5101013761
MI
Other
Enumeration date
02/06/2018
Last updated
09/20/2023
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