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NPI Code Detail

MEDICARE: DR. SAMUEL D BAIR DPT

MEDICARE:  DR. SAMUEL D BAIR  DPT
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 Therapist13072AZ

General Provider Information

NPI Number : 1578874418
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL D BAIR DPT
Provider Business Mailing Address
First Line : 625 KENMOOR AVE SE STE 100
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-2395
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1075 S IDAHO RD STE 210
Second Line :
City : APACHE JUNCTION
State : AZ
Zip : 85119-6405
Country : US
Telephone Number : 480-983-0877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2010
Last Update Date : 06/12/2024

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Directions to “ DR. SAMUEL D BAIR DPT” Practice Location

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