Individual
MICHAEL BAUMGARTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, ATC
Contact information
Practice address
441 S WHITLEY DR, FRUITLAND, ID 83619-2542
(208) 452-7197
Mailing address
441 S WHITLEY DR, FRUITLAND, ID 83619-2542
(208) 452-7197
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6575
ID
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
08/31/2015
Last updated
01/06/2020
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