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1710549605
ZACKIE KANISHKA
SANDY, UT
NPI
1710549605
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-07-01
Last Update Date
2019-07-01
Business Address
ZACKIE KANISHKA
9964 S LANNAE DR
SANDY, UT 84094-4038
Phone number: 801-644-0527
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Mailing Address
ZACKIE KANISHKA
9964 S LANNAE DR
SANDY, UT 84094-4038
Phone number: 801-644-0527
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