Provider Demographics
NPI:1881828192
Name:DALTON, ANDREA CHRISTINA (DC, R N)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:CHRISTINA
Last Name:DALTON
Suffix:
Gender:F
Credentials:DC, R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 DUNN RD
Mailing Address - Street 2:SUITE 236
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6761
Mailing Address - Country:US
Mailing Address - Phone:314-831-8877
Mailing Address - Fax:314-831-8874
Practice Address - Street 1:3533 DUNN RD
Practice Address - Street 2:SUITE 236
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6761
Practice Address - Country:US
Practice Address - Phone:314-831-8877
Practice Address - Fax:314-831-8874
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009011878111N00000X
MO2004000520163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No163W00000XNursing Service ProvidersRegistered Nurse