Provider Demographics
NPI:1972279412
Name:DAY, DANIEL CLARK (DPT, PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CLARK
Last Name:DAY
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 S RETRIEVER WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-4619
Mailing Address - Country:US
Mailing Address - Phone:208-869-7881
Mailing Address - Fax:
Practice Address - Street 1:4424 E FLAMINGO AVE STE 120
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-9291
Practice Address - Country:US
Practice Address - Phone:208-205-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist