Provider Demographics
NPI:1447053822
Name:TOLLETT, BAILEY DAVIS
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:DAVIS
Last Name:TOLLETT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 WALKER HILL ST
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-5484
Mailing Address - Country:US
Mailing Address - Phone:931-787-1715
Mailing Address - Fax:931-218-6996
Practice Address - Street 1:129 WALKER HILL ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-5484
Practice Address - Country:US
Practice Address - Phone:931-787-1715
Practice Address - Fax:931-218-6996
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8049225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist