Provider Demographics
NPI:1871887158
Name:STRATTON, DANIEL WADE (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WADE
Last Name:STRATTON
Suffix:
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 1:229 SHADOW MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-9711
Mailing Address - Country:US
Mailing Address - Phone:775-265-5277
Mailing Address - Fax:
Practice Address - Street 1:1329 US HIGHWAY 395 N
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5391
Practice Address - Country:US
Practice Address - Phone:775-782-7042
Practice Address - Fax:775-782-8479
Is Sole Proprietor?:No
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist