Basic Information
Provider Information
NPI: 1457725368
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAILEY
FirstName: ANNA
MiddleName: MELISSA
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 2531 ROCKY RIDGE RD 101
Address2:  
City: VESTAVIA
State: AL
PostalCode: 352434446
CountryCode: US
TelephoneNumber: 2059787376
FaxNumber: 2059780861
Practice Location
Address1: 104 CHELSEA POINT DR
Address2:  
City: CHELSEA
State: AL
PostalCode: 350434100
CountryCode: US
TelephoneNumber: 2054539400
FaxNumber: 2054539410
Other Information
ProviderEnumerationDate: 11/17/2015
LastUpdateDate: 11/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTH7806ALY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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