Provider Demographics
NPI:1073305686
Name:WILLIAMS, BAILEY (MAT, LAT, ATC)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MAT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-2980
Mailing Address - Country:US
Mailing Address - Phone:801-318-1394
Mailing Address - Fax:
Practice Address - Street 1:1936 NORTH ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-3940
Practice Address - Country:US
Practice Address - Phone:936-468-3401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer