Provider Demographics
NPI:1902990823
Name:DALY, PAIGE TAYLOR (PT)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:TAYLOR
Last Name:DALY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:987 CAMELOT PLACE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741
Mailing Address - Country:US
Mailing Address - Phone:606-878-6404
Mailing Address - Fax:
Practice Address - Street 1:376 MANCHESTER SQUARE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-9998
Practice Address - Country:US
Practice Address - Phone:606-598-7673
Practice Address - Fax:606-598-7948
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002499225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7850Medicare ID - Type UnspecifiedGROUP
0785001Medicare PIN