Individual
CANDACE MICHELLE BAILEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8253 HWY 51 N, STE 102, MILLINGTON, TN 38053
(901) 872-6422
(901) 872-6497
Mailing address
160 DESSIE RE DR, ATOKA, TN 38004
(901) 828-5687
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3914
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00446628
—
TN
Enumeration date
05/15/2006
Last updated
07/08/2007
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