Provider Demographics
NPI:1033197975
Name:KISERS ORTHOTIC AND PROSTHETIC SERVICES,INC.
Entity Type:Organization
Organization Name:KISERS ORTHOTIC AND PROSTHETIC SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:KISER
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:603-357-7666
Mailing Address - Street 1:25 AVON ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3510
Mailing Address - Country:US
Mailing Address - Phone:603-357-7666
Mailing Address - Fax:603-357-7043
Practice Address - Street 1:25 AVON ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3510
Practice Address - Country:US
Practice Address - Phone:603-357-7666
Practice Address - Fax:603-357-7043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0319370001Medicare NSC