Provider Demographics
NPI:1619683133
Name:CLINE, DAKOTA DAVID
Entity Type:Individual
Prefix:
First Name:DAKOTA
Middle Name:DAVID
Last Name:CLINE
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 1:25175 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:ELBERTA
Mailing Address - State:AL
Mailing Address - Zip Code:36530-2509
Mailing Address - Country:US
Mailing Address - Phone:251-284-0769
Mailing Address - Fax:
Practice Address - Street 1:25175 OLIVE ST
Practice Address - Street 2:
Practice Address - City:ELBERTA
Practice Address - State:AL
Practice Address - Zip Code:36530-2509
Practice Address - Country:US
Practice Address - Phone:251-284-0769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program