Provider Demographics
NPI:1346537552
Name:VOLTZKE, KARL DANIEL (RPH)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:DANIEL
Last Name:VOLTZKE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15800 87TH STREET NE
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330
Mailing Address - Country:US
Mailing Address - Phone:763-252-1316
Mailing Address - Fax:763-252-1326
Practice Address - Street 1:15800 87TH ST NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6546
Practice Address - Country:US
Practice Address - Phone:763-252-1316
Practice Address - Fax:763-252-1326
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist