Provider Demographics
NPI:1316533037
Name:WETSCH, KINZIE S (DC)
Entity type:Individual
Prefix:DR
First Name:KINZIE
Middle Name:S
Last Name:WETSCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KINZIE
Other - Middle Name:S
Other - Last Name:KOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1930 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0128
Mailing Address - Country:US
Mailing Address - Phone:701-226-1560
Mailing Address - Fax:
Practice Address - Street 1:3985 56TH ST S UNIT E
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4842
Practice Address - Country:US
Practice Address - Phone:701-532-0896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1135111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor