MEDICARE: MR. MICHAEL SCOTT BAILEY PT

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	225100000X	Physical Therapist	9053	OH

General Provider Information

NPI Number	:	1184838468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL SCOTT BAILEY PT

Provider Business Mailing Address
First Line	:	6146 EMERALD LAKES DR
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-7443
Country	:	US
Telephone Number	:	330-635-2059
Fax Number	:	330-725-1510

Provider Business Practice Location Address
First Line	:	6146 EMERALD LAKES DR
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-7443
Country	:	US
Telephone Number	:	330-635-2059
Fax Number	:	330-725-1510

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/08/2007

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