Healthcare Provider Details

I. General information

NPI: 1275571143
Provider Name (Legal Business Name): LAURA ELIZABETH BAUMGART PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

0 UNIVERSITY DRIVE C 132Y-A
PITTSBURGH PA
15240-1001
US

IV. Provider business mailing address

700 4TH ST #7
ASPINWALL PA
15215-3242
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-3739
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015234
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: