Provider Demographics
NPI:1235680471
Name:BAARTMAN, GREGORY
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:BAARTMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 E COLLEGE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2089
Mailing Address - Country:US
Mailing Address - Phone:507-532-2687
Mailing Address - Fax:507-337-1054
Practice Address - Street 1:1424 E COLLEGE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-2089
Practice Address - Country:US
Practice Address - Phone:507-532-2687
Practice Address - Fax:507-337-1054
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2798237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist