Individual
JERRY D. KIESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
3812 DOUGLAS AVE, DES MOINES, IA 50310-3651
(515) 255-5197
Mailing address
3812 DOUGLAS AVE, DES MOINES, IA 50310-3651
(515) 255-5197
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
4
MP
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165670
—
IA
Enumeration date
11/15/2006
Last updated
07/08/2007
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