Provider Demographics
NPI:1497983910
Name:WALTER T. BAUMGARTEL
Entity Type:Organization
Organization Name:WALTER T. BAUMGARTEL
Other - Org Name:ALBANY CHIROPRACTIC AND PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:THEODOR
Authorized Official - Last Name:BAUMGARTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-698-3181
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:45710-0008
Mailing Address - Country:US
Mailing Address - Phone:740-698-3181
Mailing Address - Fax:740-888-1849
Practice Address - Street 1:5550 ENNIS RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OH
Practice Address - Zip Code:45710-9259
Practice Address - Country:US
Practice Address - Phone:740-698-3181
Practice Address - Fax:740-888-1849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2953111N00000X
OH009790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2263438Medicaid
OHBA4042631Medicare PIN
OHHO13450Medicare PIN