Individual
MS. TIFFANY LEIGH BAITY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
606 E IL HIGHWAY 15, MOUNT VERNON, IL 62864-5072
(618) 241-7039
(618) 241-7039
Mailing address
606 E IL HIGHWAY 15, MOUNT VERNON, IL 62864-5072
(618) 241-7039
(618) 241-7039
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004630
IL
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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