Kiesel, John David

Kiesel, John David is an individual health care provider with primary practice located at 1312 W Arch Haven Ave Ste E , Bloomington IN 47403-2088. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Kiesel, John David can be contacted via phone (812) 336-8406.

Contact Information

Primary practice address
1312 W Arch Haven Ave Ste E Bloomington IN 47403-2088
Phone: (812) 336-8406
Fax: (812) 336-8342
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT60132052 Washington
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 05010388A Indiana

Profile Details

NPI number 1225233307
LBN Legal business name Kiesel, John David
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2007
Last updated Oct 27th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225233307 NPPES
Washington Other P01062853 RR MEDICARE
Washington MEDICAID 1225233307 RR MEDICARE
Washington MEDICAID 500669289 RR MEDICARE

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