Individual
MATTHEW GORDAN KISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3341 STATE ROUTE 44, ROOTSTOWN, OH 44272-9687
(330) 577-6108
Mailing address
3341 STATE ROUTE 44, ROOTSTOWN, OH 44272-9687
(330) 577-6108
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0377875
—
OH
Enumeration date
02/12/2020
Last updated
02/12/2020
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