Individual
DALTON EDWARD LUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 999-0018
Mailing address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 999-0018
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2016027193
MO
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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