Individual
MATTHEW CHRISTOPHER DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
4118 28TH ST, CINCINNATI, OH 45209-1602
(803) 237-5114
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4312
TN
363A00000X
Physician Assistant
Primary
50.007385
OH
Other
Enumeration date
05/28/2019
Last updated
02/17/2022
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