Provider Demographics
NPI:1144797176
Name:LIMBROCK, DALE C (PA-C, DMS)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:C
Last Name:LIMBROCK
Suffix:
Gender:M
Credentials:PA-C, DMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 FRANCIS CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7681
Mailing Address - Country:US
Mailing Address - Phone:719-433-5485
Mailing Address - Fax:
Practice Address - Street 1:24164 BELLEAU AVE
Practice Address - Street 2:
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22134-5106
Practice Address - Country:US
Practice Address - Phone:703-432-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical