Individual
KALYN STEVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 798-8751
(270) 956-0266
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 798-8751
(270) 956-0266
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
8754
TN
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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