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Individual

MR. ANDREW ZACHARY DALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
10701 NALL AVE STE 200, OVERLAND PARK, KS 66211-1358
(913) 381-5225
Mailing address
10701 NALL AVE STE 200, OVERLAND PARK, KS 66211-1358
(913) 381-5225

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-02041
KS
363A00000X
Physician Assistant
Primary
2017035244
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1137110
NCCPA
Enumeration date
09/19/2017
Last updated
11/28/2023
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