Individual
KYRIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7739 STATE AVE, KANSAS CITY, KS 66112-2819
(913) 788-8168
Mailing address
7739 STATE AVE, KANSAS CITY, KS 66112-2819
(316) 208-5543
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-100717
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-100717
PHARMACY LICENSE
—
Enumeration date
07/09/2020
Last updated
07/09/2020
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