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General NPI Number Information
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NPI Number | 1437792140
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Entity Type | Individual
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Provider Name | DANIEL KEY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | 1310 PREACHER ROE BLVD
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City | WEST PLAINS
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State | MO
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Zip | 65775-2938
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Country | US
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Telephone | 417-256-7114
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 N WALNUT ST
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City | WILLOW SPRINGS
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State | MO
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Zip | 65793-1228
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Country | US
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Telephone | 901-674-1018
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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 | 2018029990
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License Number State | MO
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