Healthcare Provider Details

I. General information

NPI: 1316744816
Provider Name (Legal Business Name): JACOB BAILEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 E CHICAGO ST
COLDWATER MI
49036-1703
US

IV. Provider business mailing address

408 FOX RD
COLDWATER MI
49036-9483
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-2519
  • Fax:
Mailing address:
  • Phone: 517-782-5192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301401604
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: