Provider Demographics
NPI:1801018726
Name:DALY, GENA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:GENA
Middle Name:MARIE
Last Name:DALY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:GENA
Other - Middle Name:MARIE
Other - Last Name:KASPARBAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1320 S MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-5307
Mailing Address - Country:US
Mailing Address - Phone:515-432-9525
Mailing Address - Fax:
Practice Address - Street 1:1320 S MARSHALL ST
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036-5307
Practice Address - Country:US
Practice Address - Phone:515-432-9525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002104A111N00000X
MN5252111N00000X
IA06599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN362112OtherANTHEM
INV05863Medicare UPIN
IN230250Medicare ID - Type Unspecified