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NPI Code Detail

MEDICARE: MR. MICHAEL DALTON PTA

MEDICARE: MR. MICHAEL DALTON PTA
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
1225200000XPhysical Therapy Assistant3615MA

General Provider Information

NPI Number : 1649396144
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL DALTON PTA
Provider Business Mailing Address
First Line : 181 SUMMER ST
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02740-5310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 495 NEW BOSTON RD
Second Line :
City : FALL RIVER
State : MA
Zip : 02720-5835
Country : US
Telephone Number : 508-679-0106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 07/08/2007

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