Provider Demographics
NPI:1366133407
Name:BAILEY, BOBBI LYNN (DPT)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:LYNN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BENGAR DR
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-3421
Mailing Address - Country:US
Mailing Address - Phone:570-209-6108
Mailing Address - Fax:
Practice Address - Street 1:314 FRANKLIN AVE STE 501
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1264
Practice Address - Country:US
Practice Address - Phone:410-641-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MD29582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist