Individual
KAILEY KUBESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 N OAK STREET EXT, VALDOSTA, GA 31605-6473
(229) 247-2553
Mailing address
2235 BEMISS RD, APT 1-6, VALDOSTA, GA 31602-2659
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH027557
GA
Other
Enumeration date
10/06/2013
Last updated
10/06/2013
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