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General NPI Number Information
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NPI Number | 1306120092
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Entity Type | Individual
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Provider Name | DANIELLE LANDHOLT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 6 S PERRYVILLE BLVD
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City | PERRYVILLE
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State | MO
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Zip | 63775-1267
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Country | US
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Telephone | 573-517-0029
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Fax | 573-517-0319
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Provider Business Mailing Address
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Address Line | 523 KIEFER LN
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City | PERRYVILLE
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State | MO
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Zip | 63775-7137
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Country | US
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Telephone | 573-517-3953
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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 | 2010027753
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License Number State | MO
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