Provider Demographics
NPI:1245563402
Name:BAILEY, PHILIP (DPT)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3207 220TH TRL
Mailing Address - Street 2:
Mailing Address - City:AMANA
Mailing Address - State:IA
Mailing Address - Zip Code:52203-8206
Mailing Address - Country:US
Mailing Address - Phone:319-622-3551
Mailing Address - Fax:319-622-6352
Practice Address - Street 1:411 HAGANMAN LN UNIT D
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:IA
Practice Address - Zip Code:52333-9760
Practice Address - Country:US
Practice Address - Phone:319-624-1250
Practice Address - Fax:319-624-1252
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist