Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 9028 | NC |
NPI | 1013979574 |
---|---|
Provider Name | Mr. Timothy Lamont Dalton |
First Address | Raleigh, NC 27616-8694 |
Second Address | Clayton, NC 27520-2273 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 12/10/2007 |