Provider Demographics
NPI:1437875366
Name:DAILY, MATTISON KAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATTISON
Middle Name:KAY
Last Name:DAILY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MATTISON
Other - Middle Name:KAY
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4380 E KAIBAB PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5685
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4380 E KAIBAB PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-5685
Practice Address - Country:US
Practice Address - Phone:217-972-9479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist