Provider Demographics
NPI:1336274273
Name:ROBERT J BACHMAN P T PC
Entity Type:Organization
Organization Name:ROBERT J BACHMAN P T PC
Other - Org Name:BAKER VALLEY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:541-523-8888
Mailing Address - Street 1:3950 17TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-1300
Mailing Address - Country:US
Mailing Address - Phone:541-523-8888
Mailing Address - Fax:541-523-8889
Practice Address - Street 1:3950 17TH ST STE B
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-1300
Practice Address - Country:US
Practice Address - Phone:541-523-8888
Practice Address - Fax:541-523-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1448225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR004636000OtherBLUE CROSS-BLUE SHIELD
OR071803Medicaid
OR2603084-01OtherTRICARE
ORDD7010OtherMEDICARE RAILROAD
OR071803Medicaid