Individual
JENNIFER LYN GRAVOS-BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
216 14TH AVE SW, SIDNEY, MT 59270-3519
(406) 488-2100
Mailing address
216 14TH AVE SW, SIDNEY, MT 59270-3519
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
MED-POD-LIC-114092
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2019
Last updated
08/21/2023
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