Individual
KYLE BRANDON POLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STUDENT
Contact information
Practice address
500 S PRESTON ST RM 305, LOUISVILLE, KY 40202-1702
(502) 852-8696
Mailing address
500 S PRESTON ST RM 305, LOUISVILLE, KY 40202-1702
(502) 852-8696
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
ULSOM
—
Enumeration date
05/23/2019
Last updated
05/23/2019
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