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General NPI Number Information
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NPI Number | 1225522683
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Entity Type | Individual
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Provider Name | ALONNA DANAE GALVAN
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Gender | Female
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 1008 SE LOUIS DR
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City | MULVANE
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State | KS
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Zip | 67110-1109
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Country | US
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Telephone | 316-777-1601
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Fax |
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Provider Business Mailing Address
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Address Line | 121 W MAIN ST APT B
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City | MULVANE
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State | KS
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Zip | 67110-1764
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Country | US
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Telephone | 316-734-0271
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Fax |
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 14101295
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License Number State | KS
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