Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 003010 | KY |
N | 2251X0800X | Physical Therapist - Orthopedic | 003010 | KY |
NPI | 1033316377 |
---|---|
Provider Name | Carolyn Bailey |
First Address | Burnside, KY 42519-8432 |
Second Address | Somerset, KY 42501-1952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 08/07/2007 |