Most Relevant Information
Provider Data
| NPI Number: | 1003490798 |
| Provider Name: | MITCHELL KISAMORE |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 03439726 |
Most Important Dates
| Enumeration Date: | 05/08/2021 |
| Last Updated: | 05/08/2021 |
Provider Practice Location
2630 BAILEY RD
CUYAHOGA FALLS
OH
442212216
Practice Location Phone/Fax
| Phone: | 3309235766 |
| Fax: |
Provider Mailing Location
2630 BAILEY RD
CUYAHOGA FALLS
OH
442212216
Provider Mailing Phone/Fax
| Phone: | 3309235766 |
| Fax: |