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Individual

MICHAEL DALCANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
5732 80TH ST APT 2, KENOSHA, WI 53142-4185
(262) 697-8572
Mailing address
5732 80TH ST APT 2, KENOSHA, WI 53142-4185
(262) 697-8572

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1548-19
WI

Other

Enumeration date
12/29/2011
Last updated
12/29/2011
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