Most Relevant Information
Provider Data
| NPI Number: | 1003032434 |
| Provider Name: | KYLE EUGENE CLYDE LMP |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | MA00015312 |
Most Important Dates
| Enumeration Date: | 04/17/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2809 MERIDIAN E.
EDGEWOOD
WA
98371
Practice Location Phone/Fax
| Phone: | 2538401100 |
| Fax: | 2538401199 |
Provider Mailing Location
2809 MERIDIAN E.
EDGEWOOD
WA
98371
Provider Mailing Phone/Fax
| Phone: | 2538401100 |
| Fax: | 2538401199 |