Healthcare Provider Details

I. General information

NPI: 1386667079
Provider Name (Legal Business Name): DANIEL D. O'DAY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W BOYLSTON ST
WORCESTER MA
01606-2733
US

IV. Provider business mailing address

110 W BOYLSTON ST
WORCESTER MA
01606-2733
US

V. Phone/Fax

Practice location:
  • Phone: 508-853-8400
  • Fax:
Mailing address:
  • Phone: 508-853-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number634
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: