Provider Demographics
NPI:1053651265
Name:LOBB, DANIEL JAMES (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:LOBB
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22525 WICK RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3531
Mailing Address - Country:US
Mailing Address - Phone:313-292-3755
Mailing Address - Fax:313-292-3784
Practice Address - Street 1:22525 WICK RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3531
Practice Address - Country:US
Practice Address - Phone:313-292-3755
Practice Address - Fax:313-292-3784
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist