Provider Demographics
NPI:1730674516
Name:DOTZLER, KRISTINA DANUTE (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:DANUTE
Last Name:DOTZLER
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 1:1812 CHATBURN PLZ
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537-1980
Mailing Address - Country:US
Mailing Address - Phone:712-755-2101
Mailing Address - Fax:712-755-5576
Practice Address - Street 1:1812 CHATBURN PLZ
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537-1980
Practice Address - Country:US
Practice Address - Phone:712-755-2101
Practice Address - Fax:712-755-5576
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist