MEDICARE: MR. DAVID J BAILEY DPT

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	PT013805	OH

General Provider Information

NPI Number	:	1295081131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID J BAILEY DPT

Provider Business Mailing Address
First Line	:	23175 COMMERCE PARK
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5806
Country	:	US
Telephone Number	:	440-428-6260
Fax Number	:	440-428-6276

Provider Business Practice Location Address
First Line	:	23175 COMMERCE PARK
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5806
Country	:	US
Telephone Number	:	440-428-6260
Fax Number	:	440-428-6276

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

Provider Enumeration Date	:	07/30/2012
Last Update Date	:	03/27/2019

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