Individual
CHARLES DACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
114 MCDONALD ST, LAKELAND, FL 33803-1179
(863) 293-3909
(863) 293-1909
Mailing address
114 MCDONALD ST, LAKELAND, FL 33803-1179
(863) 293-3909
(863) 293-1909
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
ME36598
FL
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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