=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356363105
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL P DAY DC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2006
-----------------------------------------------------
Last Update Date | 06/12/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1558 E NORTH RIDGE DR
-----------------------------------------------------
City | VINITA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74301-6542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-915-0312
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1558 E NORTH RIDGE DR
-----------------------------------------------------
City | VINITA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74301-6542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-915-0312
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH00003034
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------