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General NPI Number Information
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NPI Number | 1114584380
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Entity Type | Individual
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Provider Name | PHILIP KISH D.AC
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Gender | Male
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 3270 19TH ST NW STE 203
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City | ROCHESTER
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State | MN
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Zip | 55901-2951
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Country | US
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Telephone | 507-261-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 832 3RD AVE NE
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City | BYRON
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State | MN
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Zip | 55920-9783
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Country | US
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Telephone | 507-261-5439
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1797
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License Number State | MN
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