Provider Demographics
NPI:1568969863
Name:HOLLAND, BAILEY (ATC, LAT)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 PELHAM RD APT 2205
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3270
Mailing Address - Country:US
Mailing Address - Phone:559-916-1743
Mailing Address - Fax:
Practice Address - Street 1:160 FAIRFOREST WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4607
Practice Address - Country:US
Practice Address - Phone:559-916-1743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program