Individual
KIEU LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1422 E PASS RD, GULFPORT, MS 39507-3521
(228) 604-0138
Mailing address
1422 E PASS RD, GULFPORT, MS 39507-3521
(228) 604-0138
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-100293
MS
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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