Provider Demographics
NPI:1376709261
Name:BALDWIN, KRIS (PT)
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HAWKINS DR
Mailing Address - Street 2:CENTER FOR DISABILITIES AND DEVELOPMENT
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1016
Mailing Address - Country:US
Mailing Address - Phone:319-356-7409
Mailing Address - Fax:319-384-9393
Practice Address - Street 1:100 HAWKINS DR
Practice Address - Street 2:CENTER FOR DISABILITIES AND DEVELOPMENT
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1016
Practice Address - Country:US
Practice Address - Phone:319-356-7409
Practice Address - Fax:319-384-9393
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02707225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist