Organization
HAROLD D. KISTNER CONSTRUCTION COMPANY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN REED KISTNER (SEC., TREAS.)
(276) 669-7724
Entity
Organization
Contact information
Practice address
725 DAKOTA RD, BRISTOL, VA 24201-2911
(276) 669-7724
(276) 669-1116
Mailing address
725 DAKOTA RD, BRISTOL, VA 24201-2911
(276) 669-7724
(276) 669-1116
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
00020118
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0445837
BUREAU OF TENNCARE
TN
Enumeration date
05/23/2007
Last updated
08/22/2020
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