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General NPI Number Information
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NPI Number | 1427826247
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Entity Type | Individual
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Provider Name | SHERRY LYNN BAILY CMT
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Gender | Female
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 841 W MAIN ST
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City | BARSTOW
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State | CA
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Zip | 92311-2669
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Country | US
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Telephone | 760-858-0940
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Fax |
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Provider Business Mailing Address
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Address Line | 32532 SYLVAN AVE
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City | BARSTOW
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State | CA
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Zip | 92311-9698
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Country | US
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Telephone | 760-858-0940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 78758
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 78758
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License Number State | CA
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