Individual
KYLE BOYCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
324 MCHUGH DR, PACIFIC, MO 63069-6328
(314) 852-7326
Mailing address
3101 RECREATION DR, SUITE 130, WASHINGTON, MO 63090-6107
(636) 239-9979
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2007002729
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007002729
2255A2300X
MO
Enumeration date
12/01/2014
Last updated
12/01/2014
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