Provider Demographics
NPI:1275885287
Name:DALEY, JAMES THOMAS (MS, ATC, PES, SES)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:THOMAS
Last Name:DALEY
Suffix:
Gender:M
Credentials:MS, ATC, PES, SES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ELM ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:MANCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01944-1315
Mailing Address - Country:US
Mailing Address - Phone:401-378-8433
Mailing Address - Fax:
Practice Address - Street 1:376 HALE ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2096
Practice Address - Country:US
Practice Address - Phone:978-232-2445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23872255A2300X
RIAT003062255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer