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General NPI Number Information
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NPI Number | 1598971145
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Entity Type | Individual
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Provider Name | MARK ROBERT KESTLER R.PH.
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10828 KENWOOD RD
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City | CINCINNATI
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State | OH
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Zip | 45242-2812
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Country | US
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Telephone | 513-792-7080
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Fax | 513-792-3838
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Provider Business Mailing Address
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Address Line | 6990 CLAWSON RIDGE CT
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City | LIBERTY TWP
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State | OH
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Zip | 45011-9118
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Country | US
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Telephone | 513-844-1234
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03215192
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License Number State | OH
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