Individual
KISHA KAI MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
225 E BROADWAY ST, JACKSON, OH 45640-1435
(740) 710-7976
Mailing address
225 E BROADWAY ST, JACKSON, OH 45640-1435
(740) 710-7976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.381124
OH
Other
Enumeration date
11/02/2016
Last updated
12/09/2016
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