Individual
CRYSTAL MCKISSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
14 LINCOLN AVE, YEADON, PA 19050-2822
(610) 626-7700
Mailing address
14 LINCOLN AVE, YEADON, PA 19050
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
TE001843L
PA
Other
Enumeration date
04/26/2007
Last updated
02/07/2013
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