Provider Demographics
NPI:1518289222
Name:DALY, AMBER (DC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DALY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 BRODICK LN
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-6888
Mailing Address - Country:US
Mailing Address - Phone:404-438-8377
Mailing Address - Fax:
Practice Address - Street 1:1355 CHURCH STREET EXT NE
Practice Address - Street 2:SUITE C
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7962
Practice Address - Country:US
Practice Address - Phone:404-438-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor