MEDICARE: RHONDA M BAYLESS P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	6160	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3123654	OTHER	TN	BCBSTN

General Provider Information

NPI Number	:	1174614424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA M BAYLESS P.T.

Provider Business Mailing Address
First Line	:	252 LONE MTN BOAT DOCK LN
Second Line	:
City	:	TAZEWELL
State	:	TN
Zip	:	37879-6168
Country	:	US
Telephone Number	:	423-585-5023
Fax Number	:	423-587-4553

Provider Business Practice Location Address
First Line	:	280 N FAIRMONT AVE
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3768
Country	:	US
Telephone Number	:	423-585-5023
Fax Number	:	423-587-4553

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/09/2007

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