Healthcare Provider Details

I. General information

NPI: 1174614424
Provider Name (Legal Business Name): RHONDA M BAYLESS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 N FAIRMONT AVE
MORRISTOWN TN
37814-3768
US

IV. Provider business mailing address

252 LONE MTN BOAT DOCK LN
TAZEWELL TN
37879-6168
US

V. Phone/Fax

Practice location:
  • Phone: 423-585-5023
  • Fax: 423-587-4553
Mailing address:
  • Phone: 423-585-5023
  • Fax: 423-587-4553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6160
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: