Provider Demographics
NPI:1760183420
Name:BALDWIN, AARON RICHARD (LMT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:RICHARD
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 WOODBINE LN
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-3872
Mailing Address - Country:US
Mailing Address - Phone:812-213-0184
Mailing Address - Fax:
Practice Address - Street 1:1312 WOODBINE LN
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3872
Practice Address - Country:US
Practice Address - Phone:812-213-0184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT22307921225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist