Provider Demographics
NPI:1366209736
Name:BUELTEL, KEVIN
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:BUELTEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:BREDA
Mailing Address - State:IA
Mailing Address - Zip Code:51436-0345
Mailing Address - Country:US
Mailing Address - Phone:712-269-8388
Mailing Address - Fax:
Practice Address - Street 1:403 BRUNING ST
Practice Address - Street 2:
Practice Address - City:BREDA
Practice Address - State:IA
Practice Address - Zip Code:51436-7725
Practice Address - Country:US
Practice Address - Phone:712-269-8388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No347C00000XTransportation ServicesPrivate Vehicle