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NPI Code Detail

MEDICARE: DALE DAVISON P.T.

MEDICARE: DALE DAVISON P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistJ10000233DE

General Provider Information

NPI Number : 1346268547
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALE DAVISON P.T.
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1288 S GOVERNORS AVE
Second Line :
City : DOVER
State : DE
Zip : 19904-4802
Country : US
Telephone Number : 302-677-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 02/26/2013

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Directions to “ DALE DAVISON P.T.” Practice Location

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