Provider Demographics
NPI:1760015028
Name:FIELDER, BAILEE (PT)
Entity Type:Individual
Prefix:
First Name:BAILEE
Middle Name:
Last Name:FIELDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BAILEE
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7750 DANNAHER DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-4039
Mailing Address - Country:US
Mailing Address - Phone:655-121-1408
Mailing Address - Fax:
Practice Address - Street 1:7750 DANNAHER DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-4039
Practice Address - Country:US
Practice Address - Phone:865-512-1140
Practice Address - Fax:865-512-1141
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist