Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT012066L | PA |
NPI | 1356949689 |
---|---|
Provider Name | Heather D Bailey |
First Address | Windber, PA 15963-9118 |
Second Address | Johnstown, PA 15904-1948 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2020 |
Last Update Date | 09/10/2020 |