MEDICARE: DR. LAURA RENEE DAILEY 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	3463	OH
2	111N00000X	Chiropractor	DC009336	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000341814	OTHER	OH	ANTHEM BCBS

General Provider Information

NPI Number	:	1437159415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA RENEE DAILEY D.C.

Provider Business Mailing Address
First Line	:	79 WEST MAIN STREET
Second Line	:
City	:	E PALESTINE
State	:	OH
Zip	:	44413-1851
Country	:	US
Telephone Number	:	330-426-2700
Fax Number	:	330-426-9133

Provider Business Practice Location Address
First Line	:	79 WEST MAIN STREET
Second Line	:
City	:	E PALESTINE
State	:	OH
Zip	:	44413-1851
Country	:	US
Telephone Number	:	330-426-2700
Fax Number	:	330-426-9133

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

Provider Enumeration Date	:	07/30/2005
Last Update Date	:	01/09/2023

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