Provider Demographics
NPI:1679695639
Name:BAILEY, THOMAS H JR (AP)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:H
Last Name:BAILEY
Suffix:JR
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 CONKLIN DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-2616
Mailing Address - Country:US
Mailing Address - Phone:954-253-5174
Mailing Address - Fax:
Practice Address - Street 1:5132 CONKLIN DR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-2616
Practice Address - Country:US
Practice Address - Phone:954-253-5174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1709171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist