Provider Demographics
NPI:1548144900
Name:BAILEY B LMT, LLC
Entity type:Organization
Organization Name:BAILEY B LMT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR & THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BAILEY
Authorized Official - Middle Name:B R
Authorized Official - Last Name:MADDOX
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CLT, MLD-C
Authorized Official - Phone:803-569-9100
Mailing Address - Street 1:1898 CALHOUN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2650
Mailing Address - Country:US
Mailing Address - Phone:803-569-9100
Mailing Address - Fax:
Practice Address - Street 1:1898 CALHOUN ST STE 8
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2650
Practice Address - Country:US
Practice Address - Phone:803-200-1916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty