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NPI Code Detail

MEDICARE: BAILEY JOY LOOMIS

MEDICARE: BAILEY JOY LOOMIS
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
1106S00000XBehavior TechnicianWA

General Provider Information

NPI Number : 1750888467
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY JOY LOOMIS
Provider Business Mailing Address
First Line : 1321 MURFREESBORO PIKE STE 702
Second Line :
City : NASHVILLE
State : TN
Zip : 37217-2679
Country : US
Telephone Number : 615-361-4000
Fax Number : --
Provider Business Practice Location Address
First Line : 1511 JOHNSON FERRY RD STE 145
Second Line :
City : MARIETTA
State : GA
Zip : 30062-6403
Country : US
Telephone Number : 404-480-3842
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2018
Last Update Date : 02/08/2022

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Directions to “ BAILEY JOY LOOMIS ” Practice Location

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