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General NPI Number Information
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NPI Number | 1053724302
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Entity Type | Individual
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Provider Name | DANIEL GAY ATC
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Gender | Male
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 100 SAINT ANSELM DR
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City | MANCHESTER
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State | NH
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Zip | 03102-1308
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Country | US
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Telephone | 603-222-4089
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Fax | 603-222-4091
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Provider Business Mailing Address
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Address Line | 100 SAINT ANSELM DR
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City | MANCHESTER
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State | NH
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Zip | 03102-1308
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Country | US
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Telephone | 603-222-4089
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Fax | 603-222-4091
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0536
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License Number State | NH
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