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General NPI Number Information
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NPI Number | 1083766356
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Entity Type | Organization
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Legal Business Name | ADAM C. DAYLEY, O.D., P.C.
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 12/01/2008
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Provider Practice Location Address
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Address Line | 906 MICHIGAN AVE.
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City | OROFINO
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State | ID
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Zip | 83544
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Country | US
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Telephone | 208-476-3815
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Fax | 208-476-3815
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Provider Business Mailing Address
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Address Line | PO BOX 1269
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City | OROFINO
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State | ID
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Zip | 83544-1269
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Country | US
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Telephone | 208-476-3815
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Fax | 208-476-9764
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. ADAM C DAYLEY
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Credential | OD
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Telephone | 208-476-3815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODP-100032
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License Number State | ID
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