Individual
KIEFER GREG WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1926 F ST, CARSON CITY, NV 89706-2209
(775) 443-1329
Mailing address
1926 F ST, CARSON CITY, NV 89706-2209
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
154785697551610
CPR AND FIRST AID CERTIFICATION
NV
Enumeration date
05/18/2020
Last updated
05/18/2020
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