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Individual

MR. MARK KIESSLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-7840
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-7840

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
00324
CT
363A00000X
Physician Assistant
Primary
0500
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30332778
NH
05
9000180
VT
Enumeration date
06/15/2006
Last updated
10/31/2011
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