Provider Demographics
NPI:1952947368
Name:DALTON CLINIC, LLC
Entity type:Organization
Organization Name:DALTON CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-695-1609
Mailing Address - Street 1:2226 S FRASER ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4534
Mailing Address - Country:US
Mailing Address - Phone:303-695-1609
Mailing Address - Fax:
Practice Address - Street 1:2226 S FRASER ST UNIT 5
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4534
Practice Address - Country:US
Practice Address - Phone:303-695-1609
Practice Address - Fax:303-695-0382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty