Healthcare Provider Details

I. General information

NPI: 1285333476
Provider Name (Legal Business Name): BAILEY JO MARCOTTE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BAILEY JO JENKINS

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 N MAIN ST
WARREN MN
56762-1122
US

IV. Provider business mailing address

603 N MAIN ST
WARREN MN
56762-1122
US

V. Phone/Fax

Practice location:
  • Phone: 218-745-6655
  • Fax: 218-745-4049
Mailing address:
  • Phone: 218-745-6655
  • Fax: 218-745-4049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7084
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: