Individual
DR. PHILLIP ROBERT DAWALT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADAC II ADDICTIONS
Contact information
Practice address
1418 JACKSON ST, ANDERSON, IN 46016-1619
(765) 506-7329
Mailing address
207 WESTMINSTER WAY, ANDERSON, IN 46013-4462
(765) 374-9399
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25049
IN
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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