Richard Lee Kissack

NPI #1639839137 in Grand Island, Nebraska

Provider Information

NPI Number
1639839137
Entity Type
Individual
Name
Richard Lee Kissack
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Community/Behavioral Health
Enumeration Date
Dec 23, 2021
Last Updated
Dec 23, 2021

Practice Location

Address
1811 W. 2ND ST.
Address 2
SUITE 450
ZIP Code
68803-7543
Phone
(308) 379-8619

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health

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Specialized Outpatient Services

Part of Specialized Outpatient Services LLC

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