Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 097509 | IA |
NPI | 1245887991 |
---|---|
Provider Name | Dr. Kyle Bailey |
First Address | Urbandale, IA 50323-2525 |
Second Address | Des Moines, IA 50314-3045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2019 |
Last Update Date | 19/08/2019 |