Healthcare Provider Details
I. General information
NPI: 1538027552
Provider Name (Legal Business Name): DAKOTA BAUER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1770 BATHGATE RD
BETHLEHEM PA
18017-7334
US
IV. Provider business mailing address
660 W BERGER ST
EMMAUS PA
18049-2134
US
V. Phone/Fax
- Phone: 484-884-2251
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | PT033792 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: