Provider Demographics
NPI:1285040790
Name:BAUM, AARON (ATC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BAUM
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 REINHARDT DRIVE
Mailing Address - Street 2:COX COMMUNICATIONS ATHLETICS CENTER
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3074
Mailing Address - Country:US
Mailing Address - Phone:415-609-3727
Mailing Address - Fax:
Practice Address - Street 1:201 REINHARDT DRIVE
Practice Address - Street 2:COX COMMUNICATIONS ATHLETICS CENTER
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-3074
Practice Address - Country:US
Practice Address - Phone:415-609-3727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2003602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer