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General NPI Number Information
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NPI Number | 1871631200
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Entity Type | Individual
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Provider Name | LISA ROBIN BAILES D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 54 SCOTT ADAM RD STE 104
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City | COCKEYSVILLE
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State | MD
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Zip | 21030-3351
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Country | US
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Telephone | 410-252-7770
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Fax | 410-252-7774
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Provider Business Mailing Address
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Address Line | PO BOX 4036
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City | TIMONIUM
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State | MD
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Zip | 21094-4036
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Country | US
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Telephone | 410-252-7770
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Fax | 410-252-7774
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | S01507
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License Number State | MD
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