Individual
MR. JACOB BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1769 ROBERT C BYRD DR, BECKLEY, WV 25801-8707
(304) 860-1048
Mailing address
1769 ROBERT C BYRD DR, BECKLEY, WV 25801-8707
(304) 860-1048
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2501
WV
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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