Individual
MRS. JACQUELINE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP
Contact information
Practice address
2149 STUMBO RD, MANSFIELD, OH 44906-1265
(419) 545-7423
Mailing address
2149 STUMBO RD, MANSFIELD, OH 44906-1265
(419) 545-7423
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CP004121
OH
Other
Enumeration date
08/10/2018
Last updated
11/13/2019
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