Provider Demographics
NPI:1518110345
Name:BAILEY CHIROPRACTIC
Entity Type:Organization
Organization Name:BAILEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-556-2335
Mailing Address - Street 1:16846 W BELL RD
Mailing Address - Street 2:#112
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3052
Mailing Address - Country:US
Mailing Address - Phone:623-556-2335
Mailing Address - Fax:623-556-9382
Practice Address - Street 1:16846 W BELL RD
Practice Address - Street 2:#112
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3052
Practice Address - Country:US
Practice Address - Phone:623-556-2335
Practice Address - Fax:623-556-9382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ61757Medicare PIN