TODD DANIEL KISAMORE

CHARLESTON, WV
NPI1851989685
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2021-01-07
Last Update Date2022-05-10
Business Address
TODD DANIEL KISAMORE
126 MYRTLE TREE RD
CHARLESTON, WV 25309-8330
Phone number: 304-356-7073
Mailing Address
TODD DANIEL KISAMORE
126 MYRTLE TREE RD
CHARLESTON, WV 25309-8330
Phone number: 304-356-7073