Provider Demographics
NPI:1194867416
Name:HENTES, KATE WETZEL (OD)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:WETZEL
Last Name:HENTES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:WETZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10450 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48462-8200
Mailing Address - Country:US
Mailing Address - Phone:248-568-9386
Mailing Address - Fax:
Practice Address - Street 1:8129 MILLER RD
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1335
Practice Address - Country:US
Practice Address - Phone:810-635-8191
Practice Address - Fax:810-635-7595
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004299152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist