Basic Information
Provider Information
NPI: 1225682735
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BILLS
FirstName: BAYLEE
MiddleName: ERIN
NamePrefix:  
NameSuffix:  
Credential: PT DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 383 CORBIN CENTER DR
Address2:  
City: CORBIN
State: KY
PostalCode: 407011895
CountryCode: US
TelephoneNumber: 6065262909
FaxNumber: 6065262901
Practice Location
Address1: 792 CAMPBELLSVILLE RD
Address2:  
City: GREENSBURG
State: KY
PostalCode: 427431460
CountryCode: US
TelephoneNumber: 2709735400
FaxNumber: 2709735401
Other Information
ProviderEnumerationDate: 08/01/2019
LastUpdateDate: 03/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X007752KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home