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Individual

JOSEPH P DALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
610 WEST 11TH STREET, BICKNELL, IN 47512-9600
(812) 735-4834
(812) 735-4932
Mailing address
610 W 11TH ST, BICKNELL, IN 47512-9627
(812) 735-4834
(812) 735-4932

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002783
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200070850
IN
01
410036600
RRMEDICARE
IN
Enumeration date
08/22/2005
Last updated
06/25/2013
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