Individual
DANIELLE DAKOTA MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2700 S SANTA FE AVE, CHANUTE, KS 66720-3204
(620) 431-4064
(620) 431-6055
Mailing address
2700 S SANTA FE AVE, CHANUTE, KS 66720-3204
(620) 431-4064
(620) 431-6055
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-15783
KS
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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