Provider Demographics
NPI:1831434117
Name:DALY, LILA E (LMT)
Entity type:Individual
Prefix:MS
First Name:LILA
Middle Name:E
Last Name:DALY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:LILA
Other - Middle Name:E
Other - Last Name:DALY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:3619 MICHIGAN AVE APT UNIT4
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-2859
Mailing Address - Country:US
Mailing Address - Phone:720-585-9741
Mailing Address - Fax:
Practice Address - Street 1:525 N CASCADE AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3308
Practice Address - Country:US
Practice Address - Phone:720-585-9741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0020969225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist