Doctor Name: | MR. SHANE D BAUER |
NPI Number: | 1144200676 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 5173-024 |
Business Practice Address: | 355 N Peters Ave Fond Du Lac, WI - 549358258 |
Business Phone Number: | 9209299712 |
Business Fax Number: | 9209299715 |
Mailing Address: | 355 N Peters Ave, FOND DU LAC |
State: | WI |
Postal Code: | 549358258 |
Phone Number: | 9209299712 |
Fax Number: | 9209299715 |
NPI Enumeration Date: | 01/19/2006 |
NPI Last Update Date: | 07/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5173-024 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |