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General NPI Number Information
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NPI Number | 1578128997
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Entity Type | Individual
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Provider Name | BAILEY SCHENTRUP MS, ATC
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Gender | Female
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 4000 SUISUN VALLEY RD
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City | FAIRFIELD
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State | CA
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Zip | 94534-4017
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Country | US
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Telephone | 707-864-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 812 ARTHUR ST
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City | DAVIS
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State | CA
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Zip | 95616-3113
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Country | US
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Telephone | 805-727-0725
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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 | 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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