Provider Demographics
NPI:1922175421
Name:BAER, RAYMOND MARK (PT)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:MARK
Last Name:BAER
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 1:151 BALTUSROL RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-7149
Mailing Address - Country:US
Mailing Address - Phone:615-646-6018
Mailing Address - Fax:615-309-9306
Practice Address - Street 1:209 WARD CIR
Practice Address - Street 2:STE 103
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7579
Practice Address - Country:US
Practice Address - Phone:615-373-8100
Practice Address - Fax:615-309-9306
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN 4919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3646023Medicare ID - Type UnspecifiedPERFORMING PROVIDER #