Organization
KATHLEEN D KELTZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN D KELTZ O.D. (OWNER)
(712) 551-1603
Entity
Organization
Contact information
Practice address
605 9TH ST, HAWARDEN, IA 51023-2220
(712) 551-1603
(712) 551-1490
Mailing address
605 9TH ST, HAWARDEN, IA 51023-2220
(712) 551-1603
(712) 551-1490
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
01646
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0147090
—
IA
01
—
410005330
RAILROAD MEDICARE
—
05
—
9201220
—
SD
Enumeration date
11/30/2007
Last updated
12/09/2007
Update your record
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