MEDICARE: DR. DARRELL L DAY D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	08001652	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000093907	OTHER	IN	BLUE CROSS/BLUE SHIREL

General Provider Information

NPI Number	:	1083705115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARRELL L DAY D.C.

Provider Business Mailing Address
First Line	:	1509 25TH ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-4387
Country	:	US
Telephone Number	:	812-376-4080
Fax Number	:	812-376-4081

Provider Business Practice Location Address
First Line	:	1509 25TH ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-4387
Country	:	US
Telephone Number	:	812-376-4080
Fax Number	:	812-376-4081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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