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Individual

DANIEL DIXON BERK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2230 27TH AVE STE 2, MISSOULA, MT 59804-5128
(406) 926-2940
(406) 926-2944
Mailing address
2230 27TH AVE STE 2, MISSOULA, MT 59804-5128
(406) 926-2940
(406) 926-2944

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6253
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6253
MONTANA STATE LICENSE
MT
Enumeration date
02/15/2022
Last updated
02/15/2022
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