Individual
KIEL GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1326
(712) 279-2460
Mailing address
801 5TH ST, SIOUX CITY, IA 51101-1326
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23742
IA
183500000X
Pharmacist
6589
SD
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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