Provider Demographics
NPI:1326602012
Name:SANDERS, BAILEY ELIZABETH (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:ELIZABETH
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:ELIZABETH
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:475 SWANHOLME DR APT I307
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-1551
Mailing Address - Country:US
Mailing Address - Phone:615-586-7444
Mailing Address - Fax:
Practice Address - Street 1:1801 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-8259
Practice Address - Country:US
Practice Address - Phone:931-393-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2023-03-23
Deactivation Date:2019-04-30
Deactivation Code:
Reactivation Date:2019-05-22
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN28102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program