Provider Demographics
NPI:1114473881
Name:BAUER, BRITTANY (ATC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8106
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93403-8106
Mailing Address - Country:US
Mailing Address - Phone:805-546-3225
Mailing Address - Fax:805-546-3158
Practice Address - Street 1:CA HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93403
Practice Address - Country:US
Practice Address - Phone:805-546-3225
Practice Address - Fax:805-546-3158
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer