Individual
KRISTIAN KANISKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2045 S VINEYARD STE 133, MESA, AZ 85210-6893
(480) 969-0600
(480) 969-0712
Mailing address
2045 S VINEYARD STE 133, MESA, AZ 85210-6893
(480) 969-0600
(480) 969-0712
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S012951
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S012951
STATE BOARD OF PHARMACY LICENSE
AZ
Enumeration date
03/09/2018
Last updated
10/21/2020
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