Provider Demographics
NPI:1265797237
Name:GALANG, DAISY FLORENTINO (PT)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:FLORENTINO
Last Name:GALANG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 COLONEL GEORGE E DAY PKWY
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-3806
Mailing Address - Country:US
Mailing Address - Phone:573-417-0466
Mailing Address - Fax:
Practice Address - Street 1:640 COLONEL GEORGE E DAY PKWY
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-3806
Practice Address - Country:US
Practice Address - Phone:573-417-0466
Practice Address - Fax:573-471-4918
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPT 111934225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist