Provider Demographics
NPI:1629364989
Name:BAUMGARTNER PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:BAUMGARTNER PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMGARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:661-290-2884
Mailing Address - Street 1:24355 LYONS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2332
Mailing Address - Country:US
Mailing Address - Phone:661-290-2884
Mailing Address - Fax:661-290-2639
Practice Address - Street 1:24355 LYONS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2332
Practice Address - Country:US
Practice Address - Phone:661-290-2884
Practice Address - Fax:661-290-2639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty