Individual
JARRETT R KIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1315 JESSE JEWELL PKWY NE, GAINESVILLE, GA 30501-3822
(770) 219-6520
(770) 219-6521
Mailing address
601 S ENOTA DR NE, SUITE Q, GAINESVILLE, GA 30501-2400
(770) 219-6520
(770) 219-6521
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
003961
GA
Other
Enumeration date
12/06/2005
Last updated
11/29/2012
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