MEDICARE: ANNIKA BAILEY

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	2255A2300X	Athletic Trainer	AT 002556	OH

General Provider Information

NPI Number	:	1982676425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIKA BAILEY

Provider Business Mailing Address
First Line	:	45850 POMEROY PIKE
Second Line	:
City	:	RACINE
State	:	OH
Zip	:	45771-9545
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CONVOCATION CENTER
Second Line	:	OHIO UNIVERSITY
City	:	ATHENS
State	:	OH
Zip	:	45701-2979
Country	:	US
Telephone Number	:	740-593-1206
Fax Number	:

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	10/10/2014

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Directions to “ ANNIKA BAILEY ” Practice Location

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