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General NPI Number Information
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NPI Number | 1104021096
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Entity Type | Individual
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Provider Name | STEPHEN O DALEY RPH
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Gender | Male
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 830 S 2ND ST
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City | COSHOCTON
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State | OH
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Zip | 43812-1916
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Country | US
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Telephone | 740-622-2261
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Fax |
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Provider Business Mailing Address
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Address Line | 2131 DENISE DR NE
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City | NEW PHILADELPHIA
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State | OH
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Zip | 44663-9454
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Country | US
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Telephone | 330-339-7675
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-1-12190
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License Number State | OH
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