MEDICARE: BAILEY WOOD 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	16543	TN

General Provider Information

NPI Number	:	1841176435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY WOOD DPT

Provider Business Mailing Address
First Line	:	PO BOX 923
Second Line	:
City	:	BENTON
State	:	TN
Zip	:	37307-0923
Country	:	US
Telephone Number	:	423-464-4884
Fax Number	:	833-333-1455

Provider Business Practice Location Address
First Line	:	108 LIFESTYLE WAY STE 3
Second Line	:
City	:	BENTON
State	:	TN
Zip	:	37307-3914
Country	:	US
Telephone Number	:	423-464-4884
Fax Number	:	833-333-1455

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

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	08/13/2025

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Directions to “ BAILEY WOOD DPT” Practice Location

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