Individual
KAYLA YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 W BROADWAY, SOUTH BOSTON, MA 02127-2245
(617) 766-9038
Mailing address
409 W BROADWAY, SOUTH BOSTON, MA 02127-2245
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH238161
MA
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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