Healthcare Provider Details

I. General information

NPI: 1083807960
Provider Name (Legal Business Name): TREVOR BAIER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 STANGE RD
AMES IA
50010-3965
US

IV. Provider business mailing address

611 W PARK ST
URBANA IL
61801-2500
US

V. Phone/Fax

Practice location:
  • Phone: 515-956-4016
  • Fax: 515-292-7200
Mailing address:
  • Phone: 217-326-2911
  • Fax: 217-344-8047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004530
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: