Individual
LEWIS NATHAN BAUMGARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
1300 S COUNTRY CLUB RD, EL RENO, OK 73036-5304
(405) 422-1291
Mailing address
1300 S COUNTRY CLUB RD, EL RENO, OK 73036-5304
(405) 422-1291
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5840
OK
Other
Enumeration date
06/20/2020
Last updated
06/20/2020
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