GREGORY IAN LISSE

ANCHORAGE, AK
NPI1821431230
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208600000X Surgery
(Licence: AK  147767)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2013-04-16
Last Update Date2019-09-11
Business Address
Dr. GREGORY IAN LISSE
4315 DIPLOMACY DR
ANCHORAGE, AK 99508-5926
Phone number: 907-563-2662
Mailing Address
Dr. GREGORY IAN LISSE
4315 DIPLOMACY DR
ANCHORAGE, AK 99508-5926
Phone number: 907-563-2662