Individual
ALISSA R KEYSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
475 LEXINGTON AVE, MANSFIELD, OH 44907-1501
(419) 419-5705
Mailing address
417 PLYMOUTH ST APT A, PLYMOUTH, OH 44865-1027
(419) 515-9873
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
164075
OH
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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