Provider Demographics
NPI:1801590815
Name:MEADOR, DALTON (ATC)
Entity type:Individual
Prefix:
First Name:DALTON
Middle Name:
Last Name:MEADOR
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14099 MILLDALE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35444-3122
Mailing Address - Country:US
Mailing Address - Phone:205-215-2265
Mailing Address - Fax:
Practice Address - Street 1:800 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35229-0002
Practice Address - Country:US
Practice Address - Phone:205-726-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer