Individual
DR. DYLAN BOYD BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
843 FAIRVIEW AVE, BOWLING GREEN, KY 42101-4914
(270) 842-4515
(270) 842-9511
Mailing address
843 FAIRVIEW AVE, BOWLING GREEN, KY 42101-4914
(270) 842-4515
(270) 842-9511
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
011805
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011805
KENTUCKY PHARMACIST LICENSE
KY
Enumeration date
11/13/2020
Last updated
11/13/2020
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