Individual
BAILEY THIBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1930 S BROAD ST UNIT 35, PHILADELPHIA, PA 19145-2328
(267) 996-3900
Mailing address
1432 S CARLISLE ST, PHILADELPHIA, PA 19146-4813
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-1144894
DE
225100000X
Physical Therapist
PT032376
PA
Other
Enumeration date
05/30/2024
Last updated
07/10/2024
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