Provider Demographics
NPI:1326651076
Name:BAUER, PHOEBE (DPT)
Entity Type:Individual
Prefix:
First Name:PHOEBE
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 PAOLI PIKE STE 1
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9787
Mailing Address - Country:US
Mailing Address - Phone:812-903-0001
Mailing Address - Fax:812-903-0097
Practice Address - Street 1:3620 PAOLI PIKE STE 1
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9787
Practice Address - Country:US
Practice Address - Phone:812-903-0001
Practice Address - Fax:812-903-0097
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05015493A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist