Individual
MR. DREW ANTHONY HETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6127 GREEN BAY RD STE 100, KENOSHA, WI 53142-2941
(262) 652-2887
Mailing address
6127 GREEN BAY RD STE 100, KENOSHA, WI 53142-2941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5555-23
LICENSE
WI
Enumeration date
03/05/2021
Last updated
09/03/2021
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