MEDICARE: MARILYN CORINNA DAYE ATC

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	2255A2300X	Athletic Trainer	AT9929	TX
2	2255A2300X	Athletic Trainer	36003532A	IN

General Provider Information

NPI Number	:	1528563053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN CORINNA DAYE ATC

Provider Business Mailing Address
First Line	:	2499 CASSIDY RD.
Second Line	:
City	:	FORT BLISS
State	:	TX
Zip	:	79916
Country	:	US
Telephone Number	:	915-471-2448
Fax Number	:

Provider Business Practice Location Address
First Line	:	2499 CASSIDY RD.
Second Line	:
City	:	FORT BLISS
State	:	TX
Zip	:	79916
Country	:	US
Telephone Number	:	915-471-2448
Fax Number	:

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

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	12/15/2025

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