Provider Demographics
NPI:1962459354
Name:BAUER REHABILITATION SERVICES, LLC
Entity Type:Organization
Organization Name:BAUER REHABILITATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:989-430-9457
Mailing Address - Street 1:2203 CANDLESTICK LN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-3165
Mailing Address - Country:US
Mailing Address - Phone:989-430-9457
Mailing Address - Fax:989-835-9518
Practice Address - Street 1:2203 CANDLESTICK LN
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-3165
Practice Address - Country:US
Practice Address - Phone:989-430-9457
Practice Address - Fax:989-835-9518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N77310Medicare ID - Type UnspecifiedPT GROUP NUMBER
MI0N87030Medicare ID - Type Unspecified