Individual
JOHN DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1114 CENTRAL AVE, FORT DODGE, IA 50501-4004
(515) 573-3431
(515) 573-4116
Mailing address
1114 CENTRAL AVE, FORT DODGE, IA 50501-4004
(515) 573-3431
(515) 573-4116
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12617
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08161937
—
IA
Enumeration date
01/28/2019
Last updated
01/28/2019
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