Individual
EZECHIELLE KIESSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
124 QUBEIN AVE, HIGH POINT, NC 27262-4029
(410) 301-1484
Mailing address
124 QUBEIN AVE, HIGH POINT, NC 27262-4029
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
32828
NC
Other
Enumeration date
12/29/2023
Last updated
01/11/2024
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