Provider Demographics
NPI:1407258858
Name:DALRYMPLE, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DALRYMPLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 E BROWN RD
Mailing Address - Street 2:P.O. BOX 193
Mailing Address - City:MONTPELIER
Mailing Address - State:OH
Mailing Address - Zip Code:43543-2026
Mailing Address - Country:US
Mailing Address - Phone:419-485-6734
Mailing Address - Fax:
Practice Address - Street 1:1015 E BROWN RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:OH
Practice Address - Zip Code:43543-2026
Practice Address - Country:US
Practice Address - Phone:419-485-6734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1503697103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool