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General NPI Number Information
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NPI Number | 1417112681
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Entity Type | Organization
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Legal Business Name | BAILEY CHIROPRACTIC AND WELLNESS, PC
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Dates
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Enumeration Date | 07/27/2008
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 1100 CEDAR VALLEY DR STE 2
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City | CEDAR BLUFF
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State | VA
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Zip | 24609-9247
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Country | US
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Telephone | 276-964-9960
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Fax | 276-964-9964
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Provider Business Mailing Address
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Address Line | 1100 CEDAR VALLEY DR STE 2
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City | CEDAR BLUFF
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State | VA
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Zip | 24609-9247
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Country | US
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Telephone | 276-964-9960
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Fax | 276-964-9964
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JARED LEE BAILEY
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Credential | D. C.
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Telephone | 276-964-9960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104556496
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License Number State | VA
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