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NPI Code Detail

MEDICARE: HAIRSTON & DALEY PHYSICAL THERAPY, A PROFESSIONAL CORPORATION

MEDICARE: HAIRSTON & DALEY PHYSICAL THERAPY, A PROFESSIONAL CORPORATION
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
12251X0800XOrthopedic Physical Therapist

General Provider Information

NPI Number : 1154327922
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAIRSTON & DALEY PHYSICAL THERAPY, A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 1178 N TUSTIN ST
Second Line :
City : ORANGE
State : CA
Zip : 92867-6006
Country : US
Telephone Number : 714-289-7790
Fax Number : 714-289-7786
Provider Business Practice Location Address
First Line : 1178 N TUSTIN ST
Second Line :
City : ORANGE
State : CA
Zip : 92867-6006
Country : US
Telephone Number : 714-289-7790
Fax Number : 714-289-7786
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. MELANIE M EKLUND
Credential :
Telephone Number : 714-289-7790
Provider Enumeration Date : 06/24/2005
Last Update Date : 01/21/2016

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Directions to “HAIRSTON & DALEY PHYSICAL THERAPY, A PROFESSIONAL CORPORATION ” Practice Location

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