=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467596700
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL DALY DAVID D.C., D.A.C.A.N.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2007
-----------------------------------------------------
Last Update Date | 03/19/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1623 US HIGHWAY 1 SUITE B6
-----------------------------------------------------
City | SEBASTIAN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32958-3879
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-388-8788
-----------------------------------------------------
Fax | 772-388-8819
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1623 US HIGHWAY 1 SUITE B6
-----------------------------------------------------
City | SEBASTIAN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32958-3879
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-388-8788
-----------------------------------------------------
Fax | 772-388-8819
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NN0400X
-----------------------------------------------------
Taxonomy Name | Neurology Chiropractor
-----------------------------------------------------
License Number | CH0003399
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------