Provider Demographics
NPI:1720365372
Name:BAER, DANIEL (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BAER
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 S NEW ST
Mailing Address - Street 2:WEST CHESTER UNIVERSITY
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19383-0001
Mailing Address - Country:US
Mailing Address - Phone:610-436-2139
Mailing Address - Fax:
Practice Address - Street 1:855 S NEW ST
Practice Address - Street 2:WEST CHESTER UNIVERSITY
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19383-0001
Practice Address - Country:US
Practice Address - Phone:610-436-2139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0041792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer