Provider Demographics
NPI:1770927055
Name:BAILEY, ANDREA SUE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:SUE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 FOOTHILLS CENTER DR # 148
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29696-2518
Mailing Address - Country:US
Mailing Address - Phone:864-638-6405
Mailing Address - Fax:864-638-6421
Practice Address - Street 1:148 FOOTHILLS CENTER DR # 148
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:SC
Practice Address - Zip Code:29696-2518
Practice Address - Country:US
Practice Address - Phone:864-638-6405
Practice Address - Fax:864-638-6421
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1220880225100000X
SC7881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist