Provider Demographics
NPI:1982030185
Name:PRIEST, DANIEL M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:PRIEST
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 E SAN MARNAN DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5839
Mailing Address - Country:US
Mailing Address - Phone:319-236-8891
Mailing Address - Fax:319-236-9665
Practice Address - Street 1:126 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CONRAD
Practice Address - State:IA
Practice Address - Zip Code:50621-7748
Practice Address - Country:US
Practice Address - Phone:641-366-3440
Practice Address - Fax:641-366-3442
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist