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NPI 1740772086

NPI 1740772086 : BAILEE HILAMAN : SALEM, VA

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General NPI Number Information
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    NPI Number           |    1740772086
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    Entity Type          |    Individual 
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    Provider Name        |    BAILEE HILAMAN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/02/2018
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    Last Update Date     |    08/27/2022
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Provider Practice Location Address
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    Address Line         |    221 COLLEGE LN 
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    City                 |    SALEM
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    State                |    VA
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    Zip                  |    24153-3747
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    Country              |    US
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    Telephone            |    540-375-2343
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3519 FORT AVE 
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    City                 |    SALEM
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    State                |    VA
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    Zip                  |    24153-2028
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    Country              |    US
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    Telephone            |    
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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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       |    0126003634
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    License Number State |    VA
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