Provider Demographics
NPI:1336284082
Name:BAUMER, STACY VICTOR (CMT)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:VICTOR
Last Name:BAUMER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6979 S HOLLY CIR
Mailing Address - Street 2:SUITE 190
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1577
Mailing Address - Country:US
Mailing Address - Phone:303-882-0496
Mailing Address - Fax:
Practice Address - Street 1:6979 S HOLLY CIR
Practice Address - Street 2:SUITE 190
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1577
Practice Address - Country:US
Practice Address - Phone:303-882-0496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist