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Individual

MICHAEL DAVID BAILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
(208) 664-8194
(208) 667-1847
Mailing address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
(208) 664-8194
(208) 667-1847

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-948
ID
225100000X
Physical Therapist
Primary
RPT948
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010149138
BLUE SHIELD
ID
05
807192900
ID
01
TA864
BLUE CROSS
ID
Enumeration date
11/29/2006
Last updated
05/13/2026
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