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1174053920
KYLE JOHNSON
SAINT LOUIS, MO
NPI
1174053920
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MO 2017019521)
Enumeration Date
2017-06-14
Last Update Date
2017-06-14
Business Address
KYLE JOHNSON DO
12680 OLIVE BLVD STE 300
SAINT LOUIS, MO 63141-6322
Phone number: 314-251-8888
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Mailing Address
KYLE JOHNSON DO
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141-8221
Phone number: 314-251-8888
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