Provider Demographics
NPI:1205141553
Name:RICHARDS, DANIEL K
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:K
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 W LAWNDALE DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-2915
Mailing Address - Country:US
Mailing Address - Phone:801-316-0799
Mailing Address - Fax:
Practice Address - Street 1:380 W LAWNDALE DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-2915
Practice Address - Country:US
Practice Address - Phone:801-316-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6213279-8911183500000X
UT6213279-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist