Provider Demographics
NPI:1922532134
Name:BAILY, JAMES S (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:BAILY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1263
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93011-1263
Mailing Address - Country:US
Mailing Address - Phone:805-484-1909
Mailing Address - Fax:805-484-0950
Practice Address - Street 1:1814 JAKE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6642
Practice Address - Country:US
Practice Address - Phone:805-484-1909
Practice Address - Fax:805-484-0950
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 12159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor