Individual
DALLIN LANE LINDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STUDENT
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1752
(843) 692-1904
Mailing address
222 BROOKSHIRE LN, WILMINGTON, NC 28409-8006
(910) 508-8599
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO82212
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2019
Last updated
07/12/2023
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