Provider Demographics
NPI:1659567287
Name:BAILEY, DANIEL THOMAS (DC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:THOMAS
Last Name:BAILEY
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 1:108 S ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5446
Mailing Address - Country:US
Mailing Address - Phone:607-227-2504
Mailing Address - Fax:607-272-1284
Practice Address - Street 1:108 S ALBANY ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5446
Practice Address - Country:US
Practice Address - Phone:607-227-2504
Practice Address - Fax:607-272-1284
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor