Individual
ANTHONY MCKISSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1211 BENNING RD, CAPITOL HEIGHTS, MD 20743-5115
(202) 394-0237
Mailing address
1211 BENNING RD, CAPITOL HEIGHTS, MD 20743-5115
(202) 394-0237
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
0000091596
DC
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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