Individual
BAYLIE BENGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4137 TUPELO TRL, FORT WORTH, TX 76244-6930
(817) 846-8310
Mailing address
4137 TUPELO TRL, FORT WORTH, TX 76244-6930
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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