Individual
DALTON LARDINOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
617 S ROOSEVELT ST, GREEN BAY, WI 54301-3402
(920) 433-7822
Mailing address
617 S ROOSEVELT ST, GREEN BAY, WI 54301-3402
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9088-26
WI
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Enumeration date
01/27/2026
Last updated
01/29/2026
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