Individual
BRENNA MARIE KIETZMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1198 FRONT ST, TONGANOXIE, KS 66086-9707
(913) 417-7400
(913) 369-2836
Mailing address
20650 PARALLEL RD, TONGANOXIE, KS 66086-5348
(913) 626-1886
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03370
KS
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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