Individual provider · NPI-1
Bailey Rose, BOC CPED
Pedorthist · Huntsville, AL
NPI number1912583303
StatusActive
Last updated in NPPESApr 29, 2021
Details
- NPI
- 1912583303
- Entity type
- Individual (NPI-1)
- Name
- Bailey Rose
- Credential
- BOC CPED
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 24, 2021
- Certification date
- Apr 29, 2021
- Last updated
- Apr 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224L00000X | Pedorthist | – | – | Yes |
Practice location
2905 Bob Wallace Ave Sw Ste BHuntsville, AL 35805-4166
Phone 256-203-2647
Mailing address
2905 Bob Wallace Ave Sw Ste BHuntsville, AL 35805-4166
Phone 256-203-2647
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