Individual
JIM F. KISSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T. ATC
Contact information
Practice address
851 S CLINTON ST, DEFIANCE, OH 43512-2770
(419) 782-8808
(419) 782-8148
Mailing address
2610 HARPER RD, DEFIANCE, OH 43512-9133
(419) 782-8836
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7200
OH
2255A2300X
Athletic Trainer
AT002034
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2343075
—
OH
Enumeration date
02/17/2006
Last updated
07/18/2007
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