Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | S01279 | MD |
NPI | 1174693402 |
---|---|
Provider Name | Dr. Dorothy Lynn Dalton-Sheridan |
First Address | Gaithersburg, MD 20877-1824 |
Second Address | Gaithersburg, MD 20877-4152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
522228180 | FEDERAL TAX ID (01) | MD |