Search › Minnesota › 103G00000X
Jason Kisser, PH.D
NPI 1770141673 · on the registry since 2019
Practice
- Address
- 3915 Golden Valley Rd
Minneapolis, MN 55422 - Phone
- (612) 262-3464
- Organisation at this address
- Phoenix Center, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 47
Additional practice sites
- 18181 Oakwood Blvd Ste 411, Dearborn, MI
Registry record
- Primary taxonomy
- 103G00000X
103G00000X
- Also registered as
- 103G00000X
103TC0700X
103TC0700X - Licence states on file
- MI, MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-06-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota