Provider Demographics
NPI:1720060171
Name:PUTZIER, PATRICK VINCENT (AUD)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:VINCENT
Last Name:PUTZIER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 E IRON AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3232
Mailing Address - Country:US
Mailing Address - Phone:785-827-3849
Mailing Address - Fax:785-827-3849
Practice Address - Street 1:1322 E. IRON
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401
Practice Address - Country:US
Practice Address - Phone:785-827-3849
Practice Address - Fax:785-827-3849
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS751237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115406OtherMEDICARE PERFORMING PROVI
KS100314090BMedicaid
KS100314090BMedicaid
KS115406OtherMEDICARE PERFORMING PROVI