Individual
KYLE WERTZBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8803 S 101ST EAST AVE STE 100, TULSA, OK 74133-7546
(918) 579-0220
(918) 579-2309
Mailing address
1145 S UTICA AVE STE 110, TULSA, OK 74104-4013
(918) 579-3825
(918) 579-1262
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2326
OK
363AM0700X
Medical Physician Assistant
Primary
2326
OK
Other
Enumeration date
11/24/2013
Last updated
11/15/2019
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