Provider Demographics
NPI:1528628005
Name:DIAL, DANIEL OSMOND
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:OSMOND
Last Name:DIAL
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 1:252 BEAVER DM
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:WV
Mailing Address - Zip Code:25276-7920
Mailing Address - Country:US
Mailing Address - Phone:304-927-5932
Mailing Address - Fax:
Practice Address - Street 1:252 BEAVER DM
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:WV
Practice Address - Zip Code:25276-7920
Practice Address - Country:US
Practice Address - Phone:304-927-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer