Individual
MICHAEL H HETZNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
632 FREMONT ST, KIEL, WI 53042-1321
(920) 894-3322
Mailing address
632 FREMONT ST, KIEL, WI 53042-1321
(920) 894-3322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27988
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30040900
—
WI
Enumeration date
09/12/2005
Last updated
09/02/2008
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