Provider Demographics
NPI:1285779371
Name:DAUNER, LYLE R (RPHA)
Entity type:Individual
Prefix:
First Name:LYLE
Middle Name:R
Last Name:DAUNER
Suffix:
Gender:M
Credentials:RPHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N COMMERCIAL ST
Mailing Address - Street 2:PO BOX 266
Mailing Address - City:MANKATO
Mailing Address - State:KS
Mailing Address - Zip Code:66956-2206
Mailing Address - Country:US
Mailing Address - Phone:785-378-3183
Mailing Address - Fax:785-378-3809
Practice Address - Street 1:125 N COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:KS
Practice Address - Zip Code:66956-2206
Practice Address - Country:US
Practice Address - Phone:785-378-3183
Practice Address - Fax:785-378-3809
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-09661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist