Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT018940 | PA |
NPI | 1053508630 |
---|---|
Provider Name | Christopher M Bailey |
First Address | Corry, PA 16407-9014 |
Second Address | Erie, PA 16506-1040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2007 |
Last Update Date | 21/05/2021 |