Individual
BRADLEY SCOTT DALLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(801) 822-2011
Mailing address
1828 S MILLENIUM WAY, MERIDIAN, ID 83642-5036
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101872
ID
Other
Enumeration date
04/10/2014
Last updated
05/23/2019
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