Individual
KENNETH W. BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5478 S. ADAMS AVE. PKWY., SUITE #1, OGDEN, UT 84405
(801) 392-8880
Mailing address
1022 E 1425 N, LAYTON, UT 84040-8347
(801) 546-1261
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
121918-2401
UT
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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