Healthcare Provider Details

I. General information

NPI: 1942346036
Provider Name (Legal Business Name): LAUREN MICHELLE BAHR MSPT,PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 ANDERSON RD
DAVIS CA
95616-0772
US

IV. Provider business mailing address

26 HILDEBRAND CT
WOODLAND CA
95776-4930
US

V. Phone/Fax

Practice location:
  • Phone: 530-758-2222
  • Fax:
Mailing address:
  • Phone: 530-908-2658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number32895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: