Individual
DR. KEVIN TODD KISSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
66 MAIN AVENUE, PINEVILLE, WV 24874-1789
(304) 732-6322
Mailing address
PO BOX 1789, PINEVILLE, WV 24874-1789
(304) 732-6322
(304) 732-8919
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WV0945
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149996000
—
WV
Enumeration date
01/23/2006
Last updated
10/14/2010
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