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Individual

DAVID DABOLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
1710 1ST ST, ALAMOSA, CO 81101-2302
(719) 589-3658
(719) 589-0997
Mailing address
1710 1ST ST, ALAMOSA, CO 81101-2302
(719) 589-3658
(719) 589-0997

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
289
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
840706945079
ROCKY MOUNTAIN HEALTH PLA
CO
01
970028613
TRAVELERS MEDICARE
Enumeration date
10/20/2005
Last updated
08/22/2013
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