Dale Phillip Greyslak PAC

NPI 1669648754 - Physician Assistant - 363A00000X

NPI Details
NPI 1669648754
Gender Male
Enumeration Date 05/08/2008
Last Updated 03/07/2012
Entity Type Individual
Active Over 8 years ago
Practice Location
2100 N WICKHAM RD
MELBOURNE FL, 32935-8110, US
Phone (407) 451-0192
Fax
Business Location
2100 N WICKHAM RD
MELBOURNE FL, 32935-8110, US
Phone (407) 451-0192
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Florida
License Number PA9104508
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According to our database, Dale Phillip Greyslak PAC NPI is 1669648754, taxonomy code is 363A00000X and license number is PA9104508, license state is located at Florida. Dale Phillip Greyslak PAC physically located at 2100 N Wickham Rd, Melbourne FL, 32935-8110. NPI Number Dale Phillip Greyslak PAC has the Individual type.

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1669648754 NPI number is provided on an as is basis without warranty of any kind. 1669648754 is maintained by the National Plan & Provider Enumeration System. The contents of Dale Phillip Greyslak PAC are for informational purposes only.