Provider Demographics
NPI:1407515034
Name:DALTON, ARZETTA MELINDA
Entity Type:Individual
Prefix:
First Name:ARZETTA
Middle Name:MELINDA
Last Name:DALTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOUSE 80 EMORY HILL
Mailing Address - Street 2:
Mailing Address - City:HENLAWSON
Mailing Address - State:WV
Mailing Address - Zip Code:25624
Mailing Address - Country:US
Mailing Address - Phone:304-928-7044
Mailing Address - Fax:
Practice Address - Street 1:HOUSE 80 EMORY HILL
Practice Address - Street 2:
Practice Address - City:HENLAWSON
Practice Address - State:WV
Practice Address - Zip Code:25624
Practice Address - Country:US
Practice Address - Phone:304-928-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant