Healthcare Provider Details

I. General information

NPI: 1861622037
Provider Name (Legal Business Name): DALE ROBYN KANTERMAN BCND, CHS, CT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 W CONE BLVD SUITE 201
GREENSBORO NC
27408-4044
US

IV. Provider business mailing address

5311 LAND CASTLE LN
MC LEANSVILLE NC
27301-9650
US

V. Phone/Fax

Practice location:
  • Phone: 336-763-2459
  • Fax:
Mailing address:
  • Phone: 919-619-7064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: