Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 2305206115 | VA |
NPI | 1417100785 |
---|---|
Provider Name | Aubrey J. Bailey |
First Address | Garner, NC 27529-2665 |
Second Address | West Point, VA 23181-9534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2008 |
Last Update Date | 10/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1417100785 | (05) | VA |