MEDICARE: DAILEY THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	235Z00000X	Speech-Language Pathologist
3	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1275268294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAILEY THERAPY, LLC

Provider Business Mailing Address
First Line	:	113 GULF TERRACE LN
Second Line	:
City	:	PORT SAINT JOE
State	:	FL
Zip	:	32456-4745
Country	:	US
Telephone Number	:	561-351-8741
Fax Number	:	850-743-4088

Provider Business Practice Location Address
First Line	:	113 GULF TERRACE LN
Second Line	:
City	:	PORT SAINT JOE
State	:	FL
Zip	:	32456-4745
Country	:	US
Telephone Number	:	561-351-8741
Fax Number	:	850-743-4088

Authorized Official
Title or Position	:	DOCTOR OF PHYSICAL THERAPY
Name	:	DR. MATTHEW DAILEY
Credential	:	DPT
Telephone Number	:	850-544-2197

Provider Enumeration Date	:	07/22/2022
Last Update Date	:	11/17/2022

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Directions to “DAILEY THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

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