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General NPI Number Information
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NPI Number | 1780887653
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Entity Type | Individual
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Provider Name | GREGORY DADY D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6401 66TH ST
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City | PINELLAS PARK
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State | FL
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Zip | 33781-5029
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Country | US
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Telephone | 727-545-2377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 56342
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City | ST PETERSBURG
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State | FL
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Zip | 33732-6342
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Country | US
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Telephone | 727-639-1859
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | CH9252
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License Number State | FL
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