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General NPI Number Information
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NPI Number | 1609263482
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Entity Type | Individual
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Provider Name | CHAD STEVEN DAHLE RCS
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Gender | Male
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 2001 S WOODRUFF AVE SUITE 12 B
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City | IDAHO FALLS
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State | ID
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Zip | 83404-6374
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Country | US
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Telephone | 208-529-2498
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Fax | 208-528-7971
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Provider Business Mailing Address
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Address Line | 2001 S WOODRUFF AVE SUITE 12 B
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City | IDAHO FALLS
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State | ID
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Zip | 83404-6374
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Country | US
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Telephone | 208-529-2498
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Fax | 208-528-7971
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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 | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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