Provider Demographics
NPI:1588704068
Name:BAILEY, TED E (DC)
Entity type:Individual
Prefix:DR
First Name:TED
Middle Name:E
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9500 BROOKTREE RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9227
Mailing Address - Country:US
Mailing Address - Phone:724-934-0988
Mailing Address - Fax:
Practice Address - Street 1:9500 BROOKTREE RD
Practice Address - Street 2:SUITE 305
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9227
Practice Address - Country:US
Practice Address - Phone:724-934-0988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003916L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU24406Medicare UPIN
PA129622Medicare PIN