Provider Demographics
NPI:1225203623
Name:BAUMANN, ROXANNE LYNN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:LYNN
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:ROXANNE
Other - Middle Name:LYNN
Other - Last Name:RINDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:5595 COUNTY ROAD Z
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-9224
Mailing Address - Country:US
Mailing Address - Phone:262-306-2100
Mailing Address - Fax:262-365-5253
Practice Address - Street 1:5595 COUNTY ROAD Z
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-9224
Practice Address - Country:US
Practice Address - Phone:262-306-2100
Practice Address - Fax:262-365-5253
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1434-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant