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NPI Code Detail

MEDICARE: MARCY LEANN DALY D.P.T.

MEDICARE: MARCY LEANN DALY D.P.T.
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
1225100000XPhysical Therapist2297MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10000601760OTHERMTBCBS

General Provider Information

NPI Number : 1649323494
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCY LEANN DALY D.P.T.
Provider Business Mailing Address
First Line : 1016 BROOKS AVE
Second Line :
City : CORVALLIS
State : MT
Zip : 59828-9340
Country : US
Telephone Number : 406-961-3841
Fax Number : 406-961-6814
Provider Business Practice Location Address
First Line : 1016 BROOKS AVE
Second Line :
City : CORVALLIS
State : MT
Zip : 59828-9340
Country : US
Telephone Number : 406-961-3841
Fax Number : 406-961-6814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 04/06/2010

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