Individual
KYLE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
2322 HIGHWAY 17, IBERIA, MO 65486-9115
(573) 793-2050
Mailing address
2322 HIGHWAY 17, IBERIA, MO 65486-9115
(573) 792-2050
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2011021456
MO
Other
Enumeration date
11/13/2013
Last updated
11/13/2013
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