Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 001802 | CT |
N | 111NS0005X | Chiropractic Sports Physician | 001802 | CT |
NPI | 1184851750 |
---|---|
Provider Name | Dr. Renee Daly |
First Address | Westport, CT 06880 |
Second Address | Westport, CT 06880 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2009 |
Last Update Date | 01/03/2016 |