Individual
THOMAS MANFORD DALE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5925
(907) 458-5555
Mailing address
607 OLD STEESE HWY, SUITE B PMB255, FAIRBANKS, AK 99701-3131
(907) 388-0748
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
475
AK
Other
Enumeration date
09/30/2005
Last updated
10/09/2017
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