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Individual

MRS. BRENDA DEE KIOLBASA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RP

Contact information

Practice address
23 N SPRUCE ST, OGALLALA, NE 69153-2548
(308) 284-4089
(308) 284-8964
Mailing address
32635 ROAD 760, GRANT, NE 69140-2000
(308) 352-4266
(308) 284-6984

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10018
NE

Other

Enumeration date
10/17/2006
Last updated
07/08/2007
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