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General NPI Number Information
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NPI Number | 1891890091
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Entity Type | Individual
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Provider Name | KYLE KITCHEN
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1915 W 5950 S
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City | ROY
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State | UT
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Zip | 84067-1454
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Country | US
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Telephone | 801-387-8215
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Fax | 801-387-8245
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Provider Business Mailing Address
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Address Line | 1480 W 1075 S
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City | LAYTON
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State | UT
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Zip | 84041-7772
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Country | US
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Telephone | 801-593-5528
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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 | 500521-1701
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License Number State | UT
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