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General NPI Number Information
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NPI Number | 1861483679
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Entity Type | Individual
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Provider Name | ERIC D SIEKKINEN R.PH.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 10 E MAIN ST
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City | DANVILLE
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State | OH
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Zip | 43014-0070
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Country | US
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Telephone | 740-599-6744
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Fax | 740-599-6799
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Provider Business Mailing Address
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Address Line | 16631 KAYLOR RD
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City | DANVILLE
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State | OH
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Zip | 43014-9739
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Country | US
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Telephone | 740-599-5756
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Fax | 740-599-6799
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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 | 03213181
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License Number State | OH
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