Provider Demographics
NPI:1558611830
Name:DAILEY CHIROPRACTIC
Entity Type:Organization
Organization Name:DAILEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-230-0747
Mailing Address - Street 1:30 SPRING MILL CT
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-1790
Mailing Address - Country:US
Mailing Address - Phone:317-831-3877
Mailing Address - Fax:317-831-4748
Practice Address - Street 1:30 SPRING MILL CT
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1790
Practice Address - Country:US
Practice Address - Phone:317-831-3877
Practice Address - Fax:317-831-4748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002464A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty