Individual
KYLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
35401 MISSION DR, ST IGNATIUS, MT 59865-7791
(406) 745-2426
Mailing address
35401 MISSION DR, ST IGNATIUS, MT 59865-7791
(406) 745-2426
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA-PHA-LIC-69577
MT
3336C0002X
Clinic Pharmacy
Primary
PHA-PHA-LIC-69577
MT
Other
Enumeration date
12/03/2021
Last updated
03/23/2026
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