Provider Demographics
NPI:1891707295
Name:BAUGHMAN, DIANE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2266 SAINT JAMES WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-2214
Mailing Address - Country:US
Mailing Address - Phone:419-841-3922
Mailing Address - Fax:
Practice Address - Street 1:1000 REGENCY CT
Practice Address - Street 2:SUITE 105
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3091
Practice Address - Country:US
Practice Address - Phone:419-885-2322
Practice Address - Fax:419-885-5329
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT03470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist