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Individual

DR. FREDRICK KIESECKER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DC, CCN

Contact information

Practice address
2520 HYACINTH CT, WESTBURY, NY 11590-5627
(516) 334-8425
Mailing address
2520 HYACINTH CT, WESTBURY, NY 11590-5627
(516) 334-8425

Taxonomy

Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
006720
NY

Other

Enumeration date
04/05/2006
Last updated
07/09/2007
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