Individual
CARRIE A KISSINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2256 HOPKINS ST, ORANGE PARK, FL 32073-5222
(904) 534-6644
Mailing address
PO BOX 267, ORANGE PARK, FL 32067-0267
(904) 534-6644
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA49889
FL
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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