Provider Demographics
NPI:1306411897
Name:WOLTJER, ZOE (PA-C)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:WOLTJER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ZOE
Other - Middle Name:
Other - Last Name:KLEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1291
Mailing Address - Country:US
Mailing Address - Phone:989-723-8666
Mailing Address - Fax:
Practice Address - Street 1:200 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1291
Practice Address - Country:US
Practice Address - Phone:989-723-8666
Practice Address - Fax:989-725-1434
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant