Provider Demographics
NPI:1093334518
Name:MANSON, BAILEY NICOLE (MS, LAT, ATC, OTC)
Entity Type:Individual
Prefix:MS
First Name:BAILEY
Middle Name:NICOLE
Last Name:MANSON
Suffix:
Gender:F
Credentials:MS, LAT, ATC, OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 FIRETHORNE PASS
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7720
Mailing Address - Country:US
Mailing Address - Phone:404-451-8764
Mailing Address - Fax:
Practice Address - Street 1:2000 HOWARD FARM DR STE 305
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6075
Practice Address - Country:US
Practice Address - Phone:404-847-4230
Practice Address - Fax:404-847-4232
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant