| Doctor Name: | MR. DALE L TRIBOUT |
| NPI Number: | 1275533671 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN, COHN-S |
| License Number: | RN094051 |
| Business Practice Address: | 1061 Harmon Ave Ste 1d03 Ft Stewart, GA - 313145604 |
| Business Phone Number: | 9124355101 |
| Business Fax Number: | 9124355009 |
| Mailing Address: | 1061 Harmon Ave, Ste 1d03 FT STEWART |
| State: | GA |
| Postal Code: | 313145604 |
| Phone Number: | 9124355101 |
| Fax Number: | 9124355009 |
| NPI Enumeration Date: | 07/28/2005 |
| NPI Last Update Date: | 11/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WX0106X |
| License Number: | RN094051 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Occupational Health |
| Taxonomy Definition: | |