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General NPI Number Information
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NPI Number | 1972973121
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Entity Type | Individual
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Provider Name | JOSHUA KIESEL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 09/30/2015
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Provider Practice Location Address
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Address Line | 6075 BARNES RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-2603
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Country | US
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Telephone | 719-219-2793
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Fax |
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Provider Business Mailing Address
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Address Line | 9960 PROMINENT PEAK HTS APT 114
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-8665
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Country | US
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Telephone | 937-524-1267
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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 | PHA.0021059
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License Number State | CO
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