Provider Demographics
NPI:1457505075
Name:BAUMAN CHIROPRACTIC CLINIC OF NORTH WEST FLORIDA, P.A.
Entity Type:Organization
Organization Name:BAUMAN CHIROPRACTIC CLINIC OF NORTH WEST FLORIDA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:REID
Authorized Official - Last Name:BAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-785-8311
Mailing Address - Street 1:3613 N HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-9743
Mailing Address - Country:US
Mailing Address - Phone:850-785-8311
Mailing Address - Fax:850-872-9892
Practice Address - Street 1:3613 N HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-9743
Practice Address - Country:US
Practice Address - Phone:850-785-8311
Practice Address - Fax:850-872-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT56001Medicare UPIN
FLT56000Medicare UPIN