Provider Demographics
NPI:1205851185
Name:DALSIN, DEBORAH (ATC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:DALSIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 RICHLAND AVE
Mailing Address - Street 2:APT 2306
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-3211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:366 RICHLAND AVE
Practice Address - Street 2:APT 2306
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-3211
Practice Address - Country:US
Practice Address - Phone:612-590-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2083S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine