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General NPI Number Information
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NPI Number | 1235346610
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Entity Type | Individual
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Provider Name | JOHN M. DICK
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1701 E 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-1105
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Country | US
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Telephone | 620-665-2101
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Fax |
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Provider Business Mailing Address
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Address Line | 3306 DARTMOUTH RD
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City | HUTCHINSON
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State | KS
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Zip | 67502-2308
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Country | US
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Telephone | 620-664-5930
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12450
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License Number State | KS
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