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General NPI Number Information
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NPI Number | 1285197418
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Entity Type | Individual
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Provider Name | JOHN WILLIAM BAUER
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Gender | Male
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Dates
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Enumeration Date | 04/14/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 15657 W COUNTY HIGHWAY B
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City | HAYWARD
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State | WI
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Zip | 54843-2680
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Country | US
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Telephone | 715-558-3528
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Fax |
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Provider Business Mailing Address
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Address Line | 11496 N PORKYS RD
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City | HAYWARD
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State | WI
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Zip | 54843-6362
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Country | US
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Telephone | 715-634-6895
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Fax |
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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