Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 01081360A | IN |
Y | 213ES0000X | Sports Medicine | 01081360A | IN |
N | 2081S0010X | Sports Medicine | 35.097063 | OH |
N | 213ES0000X | Sports Medicine | 35.097063 | OH |
NPI | 1215149810 |
---|---|
Provider Name | Carly E Day |
First Address | Greenwood, IN 46143-7241 |
Second Address | West Lafayette, IN 47907-2117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 11/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300021658 | (05) | IN |