Individual
KEVIN LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 COLLEGE RD, FAIRBANKS, AK 99701-1706
(907) 374-4160
Mailing address
30 COLLEGE RD, FAIRBANKS, AK 99701-1706
(907) 374-4160
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
137588
AK
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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