Individual
SUSAN KISSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1227 GOSS AVE, LOUISVILLE, KY 40217-1239
(502) 363-1200
Mailing address
1359 S 2ND ST, LOUISVILLE, KY 40208-2303
(502) 423-9683
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT000674
LICENSE#
KY
Enumeration date
08/29/2006
Last updated
07/08/2007
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