Provider Demographics
NPI:1942824206
Name:DALEY, ANDREW REED (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:REED
Last Name:DALEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70689
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84170-0689
Mailing Address - Country:US
Mailing Address - Phone:801-987-8600
Mailing Address - Fax:
Practice Address - Street 1:513 1ST AVE
Practice Address - Street 2:
Practice Address - City:ZILLAH
Practice Address - State:WA
Practice Address - Zip Code:98953-9432
Practice Address - Country:US
Practice Address - Phone:509-829-5230
Practice Address - Fax:509-829-5269
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61067329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist