Individual
BRIAN PATRICK DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
NCSU SPORTS MED OFFICE, RALEIGH, NC 27695-8502
(919) 515-2111
(919) 515-6056
Mailing address
109 QUIET REFUGE LANE, GARNER, NC 27529
(919) 274-9901
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0849
NC
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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