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Individual

MS. KARLA C. BAUMGARTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1680 HIGHWAY 138 SE, CONYERS, GA 30013-1281
(770) 760-0066
(770) 922-7599
Mailing address
132 WOOD LAKE DR APT 535, ATHENS, GA 30606-6962
(706) 224-2283

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003855
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
840M83182
BLUE CROSS BLUE SHIELD
GA
Enumeration date
09/22/2017
Last updated
09/22/2017
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