# DALRAIDA CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164910543
- **Authorized official:** EUGENE ROMANO (OFFICE MANAGER)
- **Authorized official phone:** (334) 207-4466

## Contact information

- **Practice address:** 4135 ATLANTA HWY, MONTGOMERY, AL 36109-3022
- **Practice address phone:** (334) 647-1444
- **Practice address fax:** (334) 647-1404
- **Mailing address:** 4135 ATLANTA HWY, MONTGOMERY, AL 36109-3022
- **Mailing address phone:** (334) 647-1444
- **Mailing address fax:** (334) 647-1404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 2018 | AL | Yes |

## Other

- **Enumeration date:** 05/01/2018
- **Last updated:** 05/01/2018