Individual
DR. VICTOR KISSIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
19636 N 27TH AVE, SUITE 303, PHOENIX, AZ 85027-4013
(623) 879-8161
(623) 879-9204
Mailing address
PO BOX 39179, PHOENIX, AZ 85069-9179
(602) 395-0718
(602) 277-8146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3735
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
636376
—
AZ
Enumeration date
01/15/2006
Last updated
08/12/2010
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