Individual
AMANDA MARIE DAUMKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
3269 STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-2101
Mailing address
3050 HUALAPAI MOUNTAIN RD, APT. 322, KINGMAN, AZ 86401-5007
(928) 279-7673
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13968
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13968
AZ PHARMACIST LICENSE
AZ
Enumeration date
12/24/2006
Last updated
07/08/2007
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