Individual
KEVIN LANGESON KISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
352 S MAIN ST, BOX 38, ZUMBROTA, MN 55992-0038
(507) 732-7630
(507) 732-5401
Mailing address
352 S MAIN ST, BOX 38, ZUMBROTA, MN 55992-0038
(507) 732-7630
(507) 732-5401
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1673
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174523900
—
MN
Enumeration date
11/03/2005
Last updated
10/16/2008
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