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General NPI Number Information
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NPI Number | 1588217574
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Entity Type | Individual
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Provider Name | ANEIKA DALEY ATC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 1211 WHEAT ST
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City | COLUMBIA
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State | SC
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Zip | 29201
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Country | US
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Telephone | 862-273-2289
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Fax |
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Provider Business Mailing Address
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Address Line | 2025 GERVAIS ST APT 406A
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City | COLUMBIA
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State | SC
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Zip | 29204-1803
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Country | US
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Telephone | 862-273-2289
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000036548
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License Number State | NJ
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