Most Relevant Information
Provider Data
| NPI Number: | 1003525387 |
| Provider Name: | BAILEY CAROLINE FRY ATS |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/16/2022 |
| Last Updated: | 11/16/2022 |
Provider Practice Location
921 S 8TH AVE
POCATELLO
ID
832090001
Practice Location Phone/Fax
| Phone: | 2082403247 |
| Fax: |
Provider Mailing Location
5013 CONSTITUTION AVE
CHUBBUCK
ID
832023075
Provider Mailing Phone/Fax
| Phone: | 2082403247 |
| Fax: |