Individual
MR. KYLE D HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3555 W 3500 S, WEST VALLEY CITY, UT 84119-2539
(801) 963-6874
(801) 965-9953
Mailing address
3555 W 3500 S, WEST VALLEY CITY, UT 84119-2539
(801) 963-6874
(801) 965-9953
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6729880-1701
UT
Other
Enumeration date
05/28/2011
Last updated
05/28/2011
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