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General NPI Number Information
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NPI Number | 1144797176
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Entity Type | Individual
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Provider Name | DALE C LIMBROCK PA-C, DMS
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Gender | Male
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Dates
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Enumeration Date | 10/29/2018
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 24164 BELLEAU AVE
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City | QUANTICO
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State | VA
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Zip | 22134-5106
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Country | US
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Telephone | 703-432-6477
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Fax |
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Provider Business Mailing Address
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Address Line | 36 FRANCIS CT
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City | STAFFORD
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State | VA
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Zip | 22554-7681
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Country | US
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Telephone | 719-433-5485
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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