Provider Demographics
NPI:1841176435
Name:WOOD, BAILEY (DPT)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 923
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:TN
Mailing Address - Zip Code:37307-0923
Mailing Address - Country:US
Mailing Address - Phone:423-464-4884
Mailing Address - Fax:833-333-1455
Practice Address - Street 1:108 LIFESTYLE WAY STE 3
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:TN
Practice Address - Zip Code:37307-3914
Practice Address - Country:US
Practice Address - Phone:423-464-4884
Practice Address - Fax:833-333-1455
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist