MEDICARE: BAILEE CLAIRE LIPARI DPT

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	12375	LA

General Provider Information

NPI Number	:	1730010117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEE CLAIRE LIPARI DPT

Provider Business Mailing Address
First Line	:	808 STEWART DR STE A
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7433
Country	:	US
Telephone Number	:	318-606-5262
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 BARKSDALE BLVD
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4504
Country	:	US
Telephone Number	:	318-606-5262
Fax Number	:

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

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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