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1386775971
DEREK DALTON
KALISPELL, MT
NPI
1386775971
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MT 639)
Enumeration Date
2007-03-08
Last Update Date
2007-07-08
Business Address
Mr. DEREK DALTON LAC
1312 NORTH MERIDIAN
KALISPELL, MT 59904-0115
Phone number: 406-756-6453
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Mailing Address
Mr. DEREK DALTON LAC
1312 NORTH MERIDIAN
KALISPELL, MT 59904
Phone number: 406-756-6453
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