Individual
KWASI KISSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4005 LAWRENCEVILLE HWY, TUCKER, GA 30084-4620
(770) 934-3585
Mailing address
4005 LAWRENCEVILLE HWY, TUCKER, GA 30084-4620
(770) 934-3585
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
028003
GA
Other
Enumeration date
12/27/2014
Last updated
12/27/2014
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