Healthcare Provider Details

I. General information

NPI: 1912637059
Provider Name (Legal Business Name): DALTON SPORING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 SW 17TH ST STE 130
TOPEKA KS
66604-2514
US

IV. Provider business mailing address

5220 SW 17TH ST STE 130
TOPEKA KS
66604-2514
US

V. Phone/Fax

Practice location:
  • Phone: 785-271-5533
  • Fax: 785-271-8818
Mailing address:
  • Phone: 785-271-5533
  • Fax: 785-271-8818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-07954
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: