Individual
RYAN M KISSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/:
Contact information
Practice address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
(877) 787-3430
Mailing address
1015 LAS BRISAS CT # 1015, JEFFERSON CITY, MO 65101-5601
(141) 729-6244
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2018027183
MO
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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