Provider Demographics
NPI:1669262382
Name:DAANE, DARYL (RPH)
Entity type:Individual
Prefix:
First Name:DARYL
Middle Name:
Last Name:DAANE
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTONVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54929-1656
Mailing Address - Country:US
Mailing Address - Phone:715-823-4238
Mailing Address - Fax:715-823-4350
Practice Address - Street 1:201 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTONVILLE
Practice Address - State:WI
Practice Address - Zip Code:54929-1656
Practice Address - Country:US
Practice Address - Phone:715-823-4238
Practice Address - Fax:715-823-4350
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist