Individual
KELLY RENE KISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5117 CAMP RUN RD, GEORGETOWN, OH 45121-8291
(937) 822-1808
Mailing address
5117 CAMP RUN RD, GEORGETOWN, OH 45121-8291
(937) 822-1808
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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