Provider Demographics
NPI:1679131510
Name:SAMS, BAILEY CAROLINE (ATC)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:CAROLINE
Last Name:SAMS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14532 HILL CT
Mailing Address - Street 2:
Mailing Address - City:ANAMOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52205-7694
Mailing Address - Country:US
Mailing Address - Phone:319-981-1542
Mailing Address - Fax:
Practice Address - Street 1:1920 ALTA VISTA ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-4336
Practice Address - Country:US
Practice Address - Phone:563-588-4964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer