Individual
DR. GARY L KEZELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1317 W TOWNE SQUARE RD, MEQUON, WI 53092-5017
(262) 241-5099
(262) 241-5054
Mailing address
2247 MIRAMONTE CIR W, UNIT B, PALM SPRINGS, CA 92264-5781
(760) 992-3921
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1214-057
WI
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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