Organization
ECC CHATSWORTH DALTON MC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R STALEY JR. MD (PRESIDENT)
(888) 203-1274
Entity
Organization
Contact information
Practice address
1200 MEMORIAL DRIVE, DALTON, GA 30722-1168
(706) 272-6158
Mailing address
P O BOX 635919, CINCINNATI, OH 45263-5919
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
12/24/2007
Last updated
12/24/2007
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