Individual
PHILLIP A KISSACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RD LD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-6204
(319) 356-8674
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-6204
(319) 356-8674
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01464
IA
Other
Enumeration date
09/28/2005
Last updated
07/08/2007
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