Individual
TRAVIS DEAN BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 BUFFALO ST, JOHNSON CITY, TN 37604-6720
(423) 232-4130
(423) 467-3644
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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