Individual
JESSICA DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
144 S CAROL MALONE BLVD, GRAYSON, KY 41143-1352
(606) 474-7649
(606) 474-0855
Mailing address
144 S CAROL MALONE BLVD, GRAYSON, KY 41143-1352
(606) 474-7649
(606) 474-0855
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
003964
WV
225100000X
Physical Therapist
Primary
007379
KY
Other
Enumeration date
05/21/2018
Last updated
09/10/2018
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