Provider Demographics
NPI:1881762813
Name:TURNER, DALE
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:
Last Name:TURNER
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 1:9765 RANDALL DR STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1817
Mailing Address - Country:US
Mailing Address - Phone:317-222-1409
Mailing Address - Fax:317-663-3051
Practice Address - Street 1:9765 RANDALL DR
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-1816
Practice Address - Country:US
Practice Address - Phone:317-222-1409
Practice Address - Fax:317-663-3051
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05000638A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics