Provider Demographics
NPI:1144730748
Name:CHEEK, BAILEY SHUMATE
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:SHUMATE
Last Name:CHEEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 AVIAN CREST LN
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-3448
Mailing Address - Country:US
Mailing Address - Phone:276-235-1426
Mailing Address - Fax:
Practice Address - Street 1:179 COMBS ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-8429
Practice Address - Country:US
Practice Address - Phone:336-372-2441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA6088225200000X
VA2306604515225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant