Individual
KYLIE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCO
Contact information
Practice address
3025 S KENNETH PL, TEMPE, AZ 85282-3942
(480) 264-3041
Mailing address
3025 S KENNETH PL, TEMPE, AZ 85282-3942
(541) 212-3195
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374205
—
AZ
Enumeration date
07/16/2020
Last updated
07/16/2020
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