Doctor Name: | GREG BAILEN |
NPI Number: | 1750780482 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 9623 |
Business Practice Address: | 1700 Tower Dr W Stillwater, MN - 550827511 |
Business Phone Number: | 6514398540 |
Business Fax Number: | |
Mailing Address: | 7551 9th St N, Suite 100 OAKDALE |
State: | MN |
Postal Code: | 551286629 |
Phone Number: | 6517484338 |
Fax Number: | |
NPI Enumeration Date: | 08/19/2014 |
NPI Last Update Date: | 08/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 9623 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |