Individual
MICHAEL KEITH MIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
925 BEVINS COURT, LAKEPORT, CA 95453-9754
(707) 263-8383
(707) 263-5019
Mailing address
925 BEVINS COURT, LAKEPORT, CA 95453-9754
(707) 263-8383
(707) 263-5019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015421
NY
363AM0700X
Medical Physician Assistant
Primary
PA52485
CA
Other
Enumeration date
01/05/2012
Last updated
10/31/2024
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