Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC010380 | PA |
NPI | 1003947011 |
---|---|
Provider Name | Dr. Kevin Ross Bailey |
First Address | Easton, PA 18040-7642 |
Second Address | Easton, PA 18040-7642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 16/05/2014 |