Individual
STANLEY SPENCER BAYLIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, PTA
Contact information
Practice address
1526 LOMBARD ST, PHILADELPHIA, PA 19146-1625
(215) 772-1590
Mailing address
708 N 63RD ST, PHILADELPHIA, PA 19151-3803
(215) 480-1818
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE011760
PA
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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