Provider Demographics
NPI:1336623420
Name:FLEENOR, DANIEL II (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:FLEENOR
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RITTER DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MORGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25813-7709
Mailing Address - Country:US
Mailing Address - Phone:304-252-3000
Mailing Address - Fax:
Practice Address - Street 1:725 RITTER DR
Practice Address - Street 2:
Practice Address - City:GLEN MORGAN
Practice Address - State:WV
Practice Address - Zip Code:25813-7709
Practice Address - Country:US
Practice Address - Phone:304-252-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist