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1114094737
GLEN RONALD BAILEY
MERIDIAN, ID
NPI
1114094737
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT2112)
Enumeration Date
2006-11-29
Last Update Date
2007-07-08
Business Address
-- GLEN RONALD BAILEY MPT
3090 E GENTRY WAY STE 250
MERIDIAN, ID 83642-3501
Phone number: 208-888-0044
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Mailing Address
-- GLEN RONALD BAILEY MPT
3090 E GENTRY WAY STE 250
MERIDIAN, ID 83642-3501
Phone number: 208-888-0044
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