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1124720776
DALE ALAN WHITAKER
ORANGE PARK, FL
NPI
1124720776
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-03-20
Last Update Date
2023-03-20
Business Address
DALE ALAN WHITAKER
2001 KINGSLEY AVE
ORANGE PARK, FL 32073-5148
Phone number: 904-639-2112
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Mailing Address
DALE ALAN WHITAKER
2001 KINGSLEY AVE
ORANGE PARK, FL 32073-5148
Phone number: 904-639-2112
Copy
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