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General NPI Number Information
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NPI Number | 1174025506
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Entity Type | Individual
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Provider Name | ABBY LEIGH BAALMAN D.P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 314 5TH ST
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City | CARROLLTON
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State | IL
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Zip | 62016-1325
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Country | US
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Telephone | 217-409-6405
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Fax | 217-305-7282
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Provider Business Mailing Address
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Address Line | 1719 CLAWSON STREET
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City | ALTON
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State | IL
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Zip | 62002
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Country | US
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Telephone | 618-462-1133
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Fax | 618-462-3736
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070-023521
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.023521
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License Number State | IL
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