Provider Demographics
NPI:1043499627
Name:DAILY, JOHN PATRICK (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:DAILY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E HIGHWAY 246
Mailing Address - Street 2:STE, 103
Mailing Address - City:BUELLTON
Mailing Address - State:CA
Mailing Address - Zip Code:93427-9645
Mailing Address - Country:US
Mailing Address - Phone:805-688-8884
Mailing Address - Fax:805-688-8889
Practice Address - Street 1:240 E HIGHWAY 246
Practice Address - Street 2:STE, 103
Practice Address - City:BUELLTON
Practice Address - State:CA
Practice Address - Zip Code:93427-9645
Practice Address - Country:US
Practice Address - Phone:805-688-8884
Practice Address - Fax:805-688-8889
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor