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NPI Code Detail

MEDICARE: MRS. DANA BAUER R.P.T.

MEDICARE: MRS. DANA BAUER R.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2004015146MO

General Provider Information

NPI Number : 1093854762
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANA BAUER R.P.T.
Provider Business Mailing Address
First Line : 2215 NE CHIPMAN RD
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64086-1728
Country : US
Telephone Number : 816-246-6257
Fax Number : 816-246-6257
Provider Business Practice Location Address
First Line : 2133 NW 13TH ST
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64015-7734
Country : US
Telephone Number : 816-224-0003
Fax Number : 816-224-2199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 07/08/2007

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