Provider Demographics
NPI:1467593509
Name:PRYBIL, DENISE MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:MARIE
Last Name:PRYBIL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 UTAH AVE SE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-8320
Mailing Address - Country:US
Mailing Address - Phone:319-341-0937
Mailing Address - Fax:319-337-4735
Practice Address - Street 1:540 E JEFFERSON ST
Practice Address - Street 2:SUITE 104
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2477
Practice Address - Country:US
Practice Address - Phone:319-337-3966
Practice Address - Fax:319-337-4735
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist