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General NPI Number Information
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NPI Number | 1629590666
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Entity Type | Organization
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Legal Business Name | BAILEY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1450 EXECUTIVE BLVD
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City | JASPER
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State | IN
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Zip | 47546-9300
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Country | US
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Telephone | 812-634-2474
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Fax | 812-634-6038
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Provider Business Mailing Address
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Address Line | 1450 EXECUTIVE BLVD
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City | JASPER
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State | IN
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Zip | 47546-9300
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Country | US
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Telephone | 812-634-2474
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Fax | 812-634-6038
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. TRACY LYNN BAILEY
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Credential | D.C.
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Telephone | 812-634-2474
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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 | 08002558A
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License Number State | IN
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