Individual
KYLE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 GREG KRUSCHEK AVENUE, NOME, AK 99762
(907) 443-3421
Mailing address
1000 GREG KRUSCHEK AVENUE, PO BOX 966, NOME, AK 99762
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03135895
OH
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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