Provider Demographics
NPI:1932216611
Name:BAIRD, JONATHAN
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:BAIRD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9696 PINEBROOK ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-4124
Mailing Address - Country:US
Mailing Address - Phone:720-344-5634
Mailing Address - Fax:
Practice Address - Street 1:814 PERRY ST
Practice Address - Street 2:UNIT D
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3048
Practice Address - Country:US
Practice Address - Phone:303-814-2865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPTL-8940OtherLICENSE #