Provider Demographics
NPI:1356372874
Name:BAILEY, KEVIN R (PT, MPT, SCS, ATC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:R
Last Name:BAILEY
Suffix:
Gender:M
Credentials:PT, MPT, SCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HYGEIA DR
Mailing Address - Street 2:SUITE 2300 / FINANCE DEPARTMENT
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-623-7228
Mailing Address - Fax:302-623-7425
Practice Address - Street 1:200 HYGEIA DR
Practice Address - Street 2:CHRISTIANA CARE PT PLUS
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2049
Practice Address - Country:US
Practice Address - Phone:302-623-0390
Practice Address - Fax:302-623-0393
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10001625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist