Provider Demographics
NPI:1477678647
Name:DAY, ROY A (DC)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:A
Last Name:DAY
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:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-0033
Mailing Address - Country:US
Mailing Address - Phone:727-642-8636
Mailing Address - Fax:206-495-1708
Practice Address - Street 1:652 BAYSHORE DR
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-2456
Practice Address - Country:US
Practice Address - Phone:727-642-8636
Practice Address - Fax:206-495-1708
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88253Medicare ID - Type UnspecifiedUPIN-T55756