Individual
DENISE M. BROLL-DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 CRESCENT DR, SUITE 100, PHILADELPHIA, PA 19112-1015
(215) 952-9900
(215) 952-9977
Mailing address
2301 S BROAD ST, SUITE 100, PHILADELPHIA, PA 19148-3542
(215) 952-9900
(215) 952-9977
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA001026L
PA
Other
Enumeration date
10/03/2007
Last updated
03/25/2016
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