| Doctor Name: | MR. DALE ROBERT ETTER |
| NPI Number: | 1447463393 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 1974 |
| Business Practice Address: | 11527 W Peoria Ave Youngtown, AZ - 853631640 |
| Business Phone Number: | 6239334683 |
| Business Fax Number: | 6239746652 |
| Mailing Address: | 19325 N 78th Dr, GLENDALE |
| State: | AZ |
| Postal Code: | 853086089 |
| Phone Number: | 6235619196 |
| Fax Number: | |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1974 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |