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General NPI Number Information
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NPI Number | 1528071966
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Entity Type | Individual
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Provider Name | KRISSIE B. BAUER PT
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 9800 KINCEY AVE SUITE 180
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-8415
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Country | US
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Telephone | 704-948-2701
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Fax |
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Provider Business Mailing Address
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Address Line | 10039 SPRING PARK DR
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City | CHARLOTTE
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State | NC
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Zip | 28269-5204
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Country | US
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Telephone | 704-644-2916
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10673
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 10673
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License Number State | NC
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