Individual provider · Type 1 NPI

Krysta Ortlieb

Student in an Organized Health Care Education/Training Program · Watertown, NY

NPI number 1740667724 Active

Practice location

167 Polk St, Suite 300
Watertown, NY 13601-2770

Call (315) 782-7445 Map

Fax (315) 779-1184

Mailing address

PO Box 6550
Watertown, NY 13601-6550

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1740667724

Krysta Ortlieb's National Provider Identifier is 1740667724, issued on Apr 29, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Watertown, NY. The record was last updated on Apr 29, 2015.