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1063837417
JUSTIN KIETZMAN
REEDSBURG, WI
NPI
1063837417
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ND 4936)
Additional Taxonomies
247200000X Technician, Other
Enumeration Date
2014-02-21
Last Update Date
2018-07-27
Business Address
JUSTIN KIETZMAN
425 6TH ST
REEDSBURG, WI 53959
Phone number: 608-524-7907
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Mailing Address
JUSTIN KIETZMAN
425 6TH ST
REEDSBURG, WI 53959-1202
Phone number: 608-524-7907
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