Provider Demographics
NPI:1053689265
Name:LAW, DANNY G (DPH)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:G
Last Name:LAW
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 NARON RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160
Mailing Address - Country:US
Mailing Address - Phone:931-684-2067
Mailing Address - Fax:
Practice Address - Street 1:448 NARON RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-6729
Practice Address - Country:US
Practice Address - Phone:931-684-2067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist