Individual
DARRYL IVANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
407 FOXRIDGE DR, SPRINGVILLE, IN 47462-5024
(812) 583-3962
(812) 277-1259
Mailing address
407 FOXRIDGE DR, SPRINGVILLE, IN 47462-5024
(812) 583-3962
(812) 277-1259
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
015983
KY
183500000X
Pharmacist
Primary
050689-1
NY
183500000X
Pharmacist
051.290856
IL
183500000X
Pharmacist
11578
NV
183500000X
Pharmacist
16918-40
WI
183500000X
Pharmacist
26018275A
IN
183500000X
Pharmacist
32379
CA
183500000X
Pharmacist
3602
WY
183500000X
Pharmacist
8243223-1701
UT
183500000X
Pharmacist
PHA-PHA-LIC-14205
MT
183500000X
Pharmacist
PS40894
FL
183500000X
Pharmacist
RP446558
PA
183500000X
Pharmacist
RPH.03226607-2
OH
183500000X
Pharmacist
RPH023032
GA
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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