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1134985237
ANTHONY MICHAEL KISSELL
BOISE, ID
NPI
1134985237
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X Community/Behavioral Health
Enumeration Date
2024-02-26
Last Update Date
2024-02-26
Business Address
ANTHONY MICHAEL KISSELL
1276 W RIVER ST
BOISE, ID 83702-7066
Phone number: 208-338-4699
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Mailing Address
ANTHONY MICHAEL KISSELL
1276 W RIVER ST
BOISE, ID 83702-7066
Phone number: 208-338-4699
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