Provider Demographics
NPI:1184472193
Name:BAILEY, TERRY
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:BAILEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20871 STATE ROUTE 93 APT 7
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45692-9721
Mailing Address - Country:US
Mailing Address - Phone:304-923-6087
Mailing Address - Fax:
Practice Address - Street 1:20871 STATE ROUTE 93 APT 7
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OH
Practice Address - Zip Code:45692-9721
Practice Address - Country:US
Practice Address - Phone:304-923-6087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant