Individual
MR. CHARLES LYNN DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.
Contact information
Practice address
10000 BAY PINES BLVD, PROSTHETIC BLDG 23, BAY PINES, FL 33744-5005
(727) 398-6661
(727) 398-9538
Mailing address
11140 105TH AVENUE N., LARGO, FL 33778-4101
(727) 397-5583
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
N/A
FL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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