Organization Name: | DALE FOUNTAIN, DC, PS |
NPI Number: | 1144472036 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DALE FOUNTAIN (OWNER) |
Mailing Address: | 2041 E Sims Way Port Townsend |
State: | WA US |
Postal Code: | 983686905 |
Phone Number: | 3603799284 |
Fax Number: | 3603795585 |
NPI Enumeration Date: | 10/22/2008 |
NPI Last Update Date: | 02/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |