Individual
DR. BRIAN KIESNOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5605 WATERFORD LN, APPLETON, WI 54913-8438
(920) 738-7200
(920) 738-1906
Mailing address
5605 WATERFORD LN, APPLETON, WI 54913-8438
(920) 738-7200
(920) 738-1906
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
41995-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32627900
—
WI
Enumeration date
02/09/2006
Last updated
11/19/2009
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