Provider Demographics
NPI:1508184292
Name:MARSH, BAYLEY (DPT)
Entity Type:Individual
Prefix:MISS
First Name:BAYLEY
Middle Name:
Last Name:MARSH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450077 STATE ROAD 200 STE 9
Mailing Address - Street 2:
Mailing Address - City:CALLAHAN
Mailing Address - State:FL
Mailing Address - Zip Code:32011-3863
Mailing Address - Country:US
Mailing Address - Phone:904-872-2004
Mailing Address - Fax:904-879-9541
Practice Address - Street 1:450077 STATE ROAD 200 STE 9
Practice Address - Street 2:
Practice Address - City:CALLAHAN
Practice Address - State:FL
Practice Address - Zip Code:32011-3863
Practice Address - Country:US
Practice Address - Phone:904-872-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT326622251N0400X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist