Provider Demographics
NPI:1235283490
Name:CLINE, DANNIEL LEE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:DANNIEL
Middle Name:LEE
Last Name:CLINE
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 NUTMEG CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-6707
Mailing Address - Country:US
Mailing Address - Phone:574-299-7285
Mailing Address - Fax:
Practice Address - Street 1:801 E LASALLE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-2814
Practice Address - Country:US
Practice Address - Phone:574-237-7461
Practice Address - Fax:574-236-5005
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019644A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist