MEDICARE: MR. WILLIAM EDWARD BAILEY 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	PT 008396	OH

General Provider Information

NPI Number	:	1386859700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM EDWARD BAILEY P.T.

Provider Business Mailing Address
First Line	:	5080 KAREN ISLE DR
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-4348
Country	:	US
Telephone Number	:	440-951-3605
Fax Number	:

Provider Business Practice Location Address
First Line	:	4511 ROCKSIDE RD STE 330
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44131-2157
Country	:	US
Telephone Number	:	216-901-0400
Fax Number	:

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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