Kishan Modessa
Kishan Modessa is an Athletic Trainer in Allentown, Pennsylvania. Practices as a sole proprietor. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 2
Practice location Address checks out
4123 Emerson LnAllentown, PA 18104-3448
Phone: (484) 868-8977
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|---|
| Athletic Trainer | Taxonomy 2255A2300X |
Record details
| NPI number | 1972174811 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 1, 2021 |
| Last updated in NPPES | July 1, 2021 |
| Certification date | July 1, 2021 |
| Mailing address | 4123 Emerson Ln, Allentown, PA 18104-3448 |
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