Provider Demographics
NPI:1932551298
Name:DAIGLE, PAULA JANE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:JANE
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12037-1110
Mailing Address - Country:US
Mailing Address - Phone:518-392-2300
Mailing Address - Fax:518-392-8581
Practice Address - Street 1:19 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NY
Practice Address - Zip Code:12037-1110
Practice Address - Country:US
Practice Address - Phone:518-392-2300
Practice Address - Fax:518-392-8581
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor