Healthcare Provider Details

I. General information

NPI: 1336129741
Provider Name (Legal Business Name): JOAN MARIE BAUGHER PMAC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 N MAIN ST
BIGLERVILLE PA
17307
US

IV. Provider business mailing address

PO BOX 526
BIGLERVILLE PA
17307
US

V. Phone/Fax

Practice location:
  • Phone: 717-677-9288
  • Fax: 717-677-4196
Mailing address:
  • Phone: 717-677-9288
  • Fax: 717-677-4196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code211D00000X
TaxonomyPodiatric Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: