Individual
BRENTLY C KIESLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
544 S PINE ST, NOWATA, OK 74048-4020
(918) 915-1112
Mailing address
544 S PINE ST, NOWATA, OK 74048-4020
(918) 915-1112
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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