Healthcare Provider Details

I. General information

NPI: 1063694313
Provider Name (Legal Business Name): DANIEL PATRICK DRIER PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 N. MILL ST.
LA FARGE WI
54639
US

IV. Provider business mailing address

206 N. MILL ST. P.O. BOX 190
LA FARGE WI
54639-0190
US

V. Phone/Fax

Practice location:
  • Phone: 608-625-2552
  • Fax: 608-625-2553
Mailing address:
  • Phone: 608-625-2552
  • Fax: 608-625-2553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14225-040
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: