Individual
NGHIEP LY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W JEFFERSON ST., KIRKSVILLE, MO 63501
(866) 626-2878
Mailing address
3911 LA CONTENTA LN, ROUND ROCK, TX 78665-2937
(512) 767-2619
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MO
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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