Provider Demographics
NPI:1508974585
Name:DAILEY, EDWARD W (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:W
Last Name:DAILEY
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 1:412 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-2204
Mailing Address - Country:US
Mailing Address - Phone:918-834-0888
Mailing Address - Fax:
Practice Address - Street 1:412 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-2204
Practice Address - Country:US
Practice Address - Phone:918-834-0888
Practice Address - Fax:918-834-2280
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor