Individual
MR. DALTON TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, EMT, CFT
Contact information
Practice address
4901 GREEN TREE RD, READING, PA 19606-3340
(610) 914-6463
Mailing address
4901 GREEN TREE RD, READING, PA 19606-3340
(610) 914-6463
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
186907
PA
2255A2300X
Athletic Trainer
0598
NH
2255A2300X
Athletic Trainer
Primary
RT005694
PA
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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