Individual
COURTNEY BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
66 DAUGHTREY AVE APT 1010, WACO, TX 76706-1680
(817) 999-9378
Mailing address
PO BOX 1183, GRANDVIEW, TX 76050-1183
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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