Individual
MR. NICHOLAS DAKOTA DAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, PAC
Contact information
Practice address
1322 MAPLEWOOD AVE STE A, RONCEVERTE, WV 24970-8016
(304) 647-5114
Mailing address
1322 MAPLEWOOD AVE STE A, RONCEVERTE, WV 24970-8016
(304) 647-5114
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT001230
WV
363A00000X
Physician Assistant
Primary
869
WV
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/26/2014
Last updated
04/10/2026
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