Individual
KYLE DEAN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
724 N 22ND ST, SAINT JOSEPH, MO 64506-2604
(816) 396-5800
Mailing address
1106 S BEECH ST, SAVANNAH, MO 64485-2107
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2012022667
MO
Other
Enumeration date
08/15/2013
Last updated
02/02/2018
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