Brenna Marie Kietzmann
Individual provider Active NPI Physical Therapy Assistant · Tonganoxie, KS
NPI 1699324665 · NPPES record last updated Sep 11, 2019
Key facts
- NPI
- 1699324665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 14-03370 (KS)
- Practice address
- 1198 Front St
Tonganoxie, KS 66086-9707 - Phone
- (913) 417-7400
- Fax
- (913) 369-2836
- NPI assigned
- Sep 11, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-03370 | KS | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14-03370 | KS | Yes |
Addresses
Primary practice location
1198 Front St
Tonganoxie, KS 66086-9707
Mailing address
20650 Parallel Rd
Tonganoxie, KS 66086-5348
Phone (913) 626-1886
Other providers in Tonganoxie, KS
- David H Jaeger
- JRR, DDS, LLC
- Aryn Kamerer
- Kelsey Kearns
- Brittany Keever
- Samantha Kirkwood
- Carrie Koch
- Maria Korjenevski
- Tara Krajewski
- Cynthia Kraus
All providers in Tonganoxie, KS · Physical Therapy Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.