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NPI Code Detail

MEDICARE: JOHN D DALTON DC

MEDICARE:   JOHN D DALTON  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor1273NM

General Provider Information

NPI Number : 1174577555
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN D DALTON DC
Provider Business Mailing Address
First Line : 313 W COUNTRY CLUB RD STE 5
Second Line :
City : ROSWELL
State : NM
Zip : 88201-5804
Country : US
Telephone Number : 575-625-0039
Fax Number : 877-900-8327
Provider Business Practice Location Address
First Line : 313 W COUNTRY CLUB RD STE 5
Second Line :
City : ROSWELL
State : NM
Zip : 88201-5804
Country : US
Telephone Number : 575-625-0039
Fax Number : 877-900-8327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 10/01/2012

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Directions to “ JOHN D DALTON DC” Practice Location

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