Individual
MS. KELLEE S. KIETZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
8575 RIXLEW LANE, MANASSAS, VA 20109
(703) 257-9770
(703) 257-2937
Mailing address
10340 LAUNCH CIR APT 203, MANASSAS, VA 20109-4263
(703) 973-3068
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602077
VA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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