Provider Demographics
NPI:1821563487
Name:CATON, BAILEY ROSE (LAT, ATC)
Entity Type:Individual
Prefix:MISS
First Name:BAILEY
Middle Name:ROSE
Last Name:CATON
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65480 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-8528
Mailing Address - Country:US
Mailing Address - Phone:269-548-5315
Mailing Address - Fax:
Practice Address - Street 1:65480 22ND ST
Practice Address - Street 2:
Practice Address - City:MATTAWAN
Practice Address - State:MI
Practice Address - Zip Code:49071-8528
Practice Address - Country:US
Practice Address - Phone:269-548-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010020682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer