Individual
MR. CHARLES LEE BAUMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1458-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40014300
—
WI
Enumeration date
04/22/2008
Last updated
09/10/2012
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