MR. Corey Lee Kisser

NPI #1962762393 in Forest Grove, Oregon

Provider Information

NPI Number: 1962762393
Entity Type: Individual
Name: MR. Corey Lee Kisser
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: May 18, 2012
Last Updated: May 18, 2012

Practice Location

Address: 3541 17TH CT
City: Forest Grove
State: Oregon
ZIP Code: 97116-2102
Phone: (503) 319-9763

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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