Healthcare Provider Details

I. General information

NPI: 1619968369
Provider Name (Legal Business Name): DAN LEE SOMSEN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 W. 3RD ST.
YANKTON SD
57078
US

IV. Provider business mailing address

2106 BURLEIGH ST.
YANKTON SD
57078
US

V. Phone/Fax

Practice location:
  • Phone: 605-665-7865
  • Fax: 605-665-0452
Mailing address:
  • Phone: 605-668-0796
  • Fax: 605-665-0452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4019
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: