Provider Demographics
NPI:1003126566
Name:SAUTTER, KYLE (RPH)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:
Last Name:SAUTTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2406
Mailing Address - Country:US
Mailing Address - Phone:989-686-6820
Mailing Address - Fax:989-684-1229
Practice Address - Street 1:4001 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2406
Practice Address - Country:US
Practice Address - Phone:989-686-6820
Practice Address - Fax:989-684-1229
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist