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General NPI Number Information
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NPI Number | 1659781300
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Entity Type | Organization
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Legal Business Name | COLTMAN AND BAUGHMAN PHYSICAL THERAPY PA
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Dates
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Enumeration Date | 05/04/2014
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 2370-2 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4023
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Country | US
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Telephone | 904-853-5106
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Fax | 904-853-5107
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Provider Business Mailing Address
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Address Line | 2370-2 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4023
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Country | US
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Telephone | 904-853-5106
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Fax | 904-853-5107
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Authorized Official
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Title or Position | PARTNER
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Name | MARK HENRY BAUGHMAN
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Credential | PT
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Telephone | 904-853-5106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 19458
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License Number State | FL
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