Provider Demographics
NPI:1154448694
Name:DALTON, MARC T (DPT)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:T
Last Name:DALTON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:12110 COLONY PRESERVE DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-5804
Mailing Address - Country:US
Mailing Address - Phone:203-982-9878
Mailing Address - Fax:
Practice Address - Street 1:5155 W ATLANTIC AVE STE C
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8170
Practice Address - Country:US
Practice Address - Phone:561-637-7195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL266962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic