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NPI Code Detail

MEDICARE: TIMOTHY BAILEY D.C.

MEDICARE:   TIMOTHY  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
1111N00000XChiropractor8110750-1202UT

General Provider Information

NPI Number : 1891063731
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY BAILEY D.C.
Provider Business Mailing Address
First Line : 1260 N 200 E STE 16
Second Line :
City : LOGAN
State : UT
Zip : 84341-2382
Country : US
Telephone Number : 435-245-7555
Fax Number : 435-245-7607
Provider Business Practice Location Address
First Line : 1260 N 200 E STE 16
Second Line :
City : LOGAN
State : UT
Zip : 84341-2382
Country : US
Telephone Number : 435-245-7555
Fax Number : 435-245-7607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2011
Last Update Date : 12/07/2018

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Directions to “ TIMOTHY BAILEY D.C.” Practice Location

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