Provider Demographics
NPI:1760580542
Name:BALDWIN, PATRICK CHARLES (PT)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:CHARLES
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 313
Mailing Address - Street 2:
Mailing Address - City:KEVIL
Mailing Address - State:KY
Mailing Address - Zip Code:42053-8976
Mailing Address - Country:US
Mailing Address - Phone:270-462-8252
Mailing Address - Fax:270-462-8253
Practice Address - Street 1:203 KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:KEVIL
Practice Address - State:KY
Practice Address - Zip Code:42053-8976
Practice Address - Country:US
Practice Address - Phone:270-462-8252
Practice Address - Fax:270-462-8253
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist