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Individual

ABBY M GIETZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7777
(605) 882-7801
Mailing address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7777
(605) 882-7801

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0971
SD
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0971
STATE LICENSE
SD
Enumeration date
01/22/2015
Last updated
01/22/2021
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