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Individual

ANTHONY BAILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
1110 LONDON ST, SUITE 105, MYRTLE BEACH, SC 29577-5799
(843) 742-6040
Mailing address
684 LALTON DR, CONWAY, SC 29526-7872
(512) 569-2398

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
245
SC

Other

Enumeration date
10/23/2015
Last updated
10/17/2016
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