Healthcare Provider Details

I. General information

NPI: 1851574743
Provider Name (Legal Business Name): ELLEN MAUREEN DALY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 06/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5557 CHEVIOT RD
CINCINNATI OH
45247-7020
US

IV. Provider business mailing address

5557 CHEVIOT RD
CINCINNATI OH
45247-7020
US

V. Phone/Fax

Practice location:
  • Phone: 513-923-1700
  • Fax: 513-741-6631
Mailing address:
  • Phone: 513-923-1700
  • Fax: 513-741-6631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number04277
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number04277
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: