Provider Demographics
NPI:1831337393
Name:BAILEY, MOLLY M (DPT)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:M
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:M
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:830 1ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5004
Mailing Address - Country:US
Mailing Address - Phone:319-369-8107
Mailing Address - Fax:
Practice Address - Street 1:1330 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5010
Practice Address - Country:US
Practice Address - Phone:319-398-1569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004350225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA004350OtherIOWA PT LICENSE
IAIB1212Medicare PIN
IAIB1212030Medicare PIN
IAIB1213030Medicare PIN
IA004350OtherIOWA PT LICENSE
IAI18344014Medicare Oscar/Certification