MEDICARE: MR. MELVIN LEE BAILEY LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	0019010486	VA

General Provider Information

NPI Number	:	1023978749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MELVIN LEE BAILEY LMT

Provider Business Mailing Address
First Line	:	14 CORIN WAY
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-9453
Country	:	US
Telephone Number	:	571-605-8945
Fax Number	:

Provider Business Practice Location Address
First Line	:	2046 RICHMOND HWY STE D
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-7276
Country	:	US
Telephone Number	:	571-605-8945
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	11/14/2025

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