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NPI 1104445121

NPI 1104445121 : PATRICK MICHAEL GUNN PHARMD : CHEROKEE, IA

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General NPI Number Information
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    NPI Number           |    1104445121
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICK MICHAEL GUNN PHARMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/09/2020
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    Last Update Date     |    04/09/2020
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Provider Practice Location Address
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    Address Line         |    800 N 2ND ST 
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    City                 |    CHEROKEE
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    State                |    IA
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    Zip                  |    51012-1278
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    Country              |    US
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    Telephone            |    712-225-6121
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    Fax                  |    712-225-3782
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Provider Business Mailing Address
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    Address Line         |    800 N 2ND ST 
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    City                 |    CHEROKEE
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    State                |    IA
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    Zip                  |    51012-1278
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    Country              |    US
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    Telephone            |    712-225-6121
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    Fax                  |    712-225-3782
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    23379
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    License Number State |    IA
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