Individual
LESLIE W DALTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 4TH AVE, CANYON, TX 79016-0001
(806) 651-5108
(806) 651-5105
Mailing address
2415 15TH AVE, CANYON, TX 79015-5519
(806) 656-0788
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
104700
TX
235Z00000X
Speech-Language Pathologist
104700
TX
Other
Enumeration date
06/06/2012
Last updated
10/23/2012
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