Bailey Deatherage

NPI #1043942444 in Alvarado, Texas

Provider Information

NPI Number: 1043942444
Entity Type: Individual
Name: Bailey Deatherage
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jun 26, 2022
Last Updated: Jun 26, 2022

Practice Location

Address: 8224 COUNTY ROAD 604
City: Alvarado
State: Texas
ZIP Code: 76009-8642
Phone: (682) 472-2569

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X

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