Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 033463 | GA |
NPI | 1053353078 |
---|---|
Provider Name | Dr. Dale Christian Strasser |
First Address | Atlanta, GA 30322-1004 |
Second Address | Atlanta, GA 30322-1004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 24/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00438204A | (05) | GA |
BS1104671 | DEA (01) | GA |
E-24589 | (02) | GA |