Individual
MR. MICHAEL HOWARD BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT CFMT
Contact information
Practice address
321 HOLLY STREET, JUNCTION CITY, OR 97448-0275
(541) 998-9988
(541) 998-9987
Mailing address
PO BOX 275, 321 HOLLY STREET, JUNCTION CITY, OR 97448-0275
(541) 998-9988
(541) 998-6280
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2756
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130604
—
OR
01
—
2382
TIN
—
Enumeration date
11/06/2006
Last updated
07/08/2007
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