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General NPI Number Information
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NPI Number | 1003194481
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Entity Type | Organization
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Legal Business Name | DALTON MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 08/02/2011
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 1219 S EAST AVE STE 202
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City | SARASOTA
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State | FL
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Zip | 34239-2340
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Country | US
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Telephone | 941-706-1490
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Fax |
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Provider Business Mailing Address
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Address Line | 33 S GULFSTREAM AVE UNIT 609
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City | SARASOTA
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State | FL
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Zip | 34236-8938
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Country | US
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Telephone | 941-706-1490
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | GLORIA M DALTON
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Credential | DOM AP
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Telephone | 941-706-1490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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