Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist |
NPI | 1003260746 |
---|---|
Provider Name | Katrina Baumann |
First Address | Apo, AP 96278-2060 |
Second Address | Apo, AP 96278 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2016 |
Last Update Date | 17/05/2019 |