Provider Demographics
NPI:1164479366
Name:BAIER, FREDERICK RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:RAY
Last Name:BAIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 WALNUT ST
Mailing Address - Street 2:STE 1
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1750
Mailing Address - Country:US
Mailing Address - Phone:712-254-2639
Mailing Address - Fax:
Practice Address - Street 1:704 WALNUT ST
Practice Address - Street 2:STE 1
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1750
Practice Address - Country:US
Practice Address - Phone:712-254-2639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06641111N00000X
KS4839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor