Kyle Lee Bastie CPO

NPI 1790960482 - Contractor - 171W00000X

NPI Details
NPI 1790960482
Gender Male
Enumeration Date 01/01/2008
Last Updated 01/01/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1432 MADISON 212
FREDERICKTOWN MO, 63645-8208, US
Phone (520) 904-1079
Fax
Business Location
1432 MADISON 212
FREDERICKTOWN MO, 63645-8208, US
Phone (520) 904-1079
Fax
Toxanomy
Taxonomy Code 171W00000X
License State
License Number
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According to our database, Kyle Lee Bastie CPO NPI is 1790960482, taxonomy code is 171W00000X Kyle Lee Bastie CPO physically located at 1432 Madison 212, Fredericktown MO, 63645-8208. NPI Number Kyle Lee Bastie CPO has the Individual type.

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1790960482 NPI number is provided on an as is basis without warranty of any kind. 1790960482 is maintained by the National Plan & Provider Enumeration System. The contents of Kyle Lee Bastie CPO are for informational purposes only.