Individual
DR. KYLE PATRICK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
559 VINCENT ST., SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE, CO 80914
(719) 556-1109
Mailing address
559 VINCENT ST., SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE, CO 80914
(719) 556-1109
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
35650
SC
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
35650
SC
Other
Enumeration date
06/04/2014
Last updated
07/16/2024
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