Provider Demographics
NPI:1023022241
Name:BAUMANN, DEBRA (PT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:BAUMANN
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 1:2600 RIB MOUNTAIN DR STE 220
Mailing Address - Street 2:PHYSIOTHERAPY ASSOCIATES
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7196
Mailing Address - Country:US
Mailing Address - Phone:715-843-5300
Mailing Address - Fax:715-843-5329
Practice Address - Street 1:2600 RIB MOUNTAIN DR STE 220
Practice Address - Street 2:PHYSIOTHERAPY ASSOCIATES
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7196
Practice Address - Country:US
Practice Address - Phone:715-843-5300
Practice Address - Fax:715-843-5329
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9765225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40365200Medicaid
83070-000Medicare ID - Type Unspecified