Provider Demographics
NPI:1538702006
Name:BAAREMAN, JASON REID (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:REID
Last Name:BAAREMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 W WHEELER PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1895
Mailing Address - Country:US
Mailing Address - Phone:706-721-6340
Mailing Address - Fax:706-210-2036
Practice Address - Street 1:1220 W WHEELER PKWY STE E
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1895
Practice Address - Country:US
Practice Address - Phone:706-721-6340
Practice Address - Fax:706-210-2036
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist