Individual
DR. KEVIN ELLIS VIESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, ATC, CCSP
Contact information
Practice address
331 OAK MANOR DR STE 101, GLEN BURNIE, MD 21061-5553
(410) 766-4878
Mailing address
331 OAK MANOR DR STE 101, GLEN BURNIE, MD 21061-5553
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
C16755
MD
Other
Enumeration date
11/08/2017
Last updated
11/24/2020
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