MEDICARE: JARED LEE BAILEY D.C.

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	111N00000X	Chiropractor	0104556496	VA

General Provider Information

NPI Number	:	1366512303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED LEE BAILEY D.C.

Provider Business Mailing Address
First Line	:	1100 CEDAR VALLEY DR STE 2
Second Line	:
City	:	CEDAR BLUFF
State	:	VA
Zip	:	24609-9247
Country	:	US
Telephone Number	:	276-964-9960
Fax Number	:	276-964-9964

Provider Business Practice Location Address
First Line	:	1100 CEDAR VALLEY DR STE 2
Second Line	:
City	:	CEDAR BLUFF
State	:	VA
Zip	:	24609-9247
Country	:	US
Telephone Number	:	276-964-9960
Fax Number	:	276-964-9964

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	05/01/2020

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