Individual
DANIEL RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
104 N LOMBARD ST, MAHOMET, IL 61853-9097
(217) 586-3460
(217) 586-3523
Mailing address
104 N LOMBARD ST, MAHOMET, IL 61853-9097
(217) 586-3460
(217) 586-3523
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051294646
IL
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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