Individual
MRS. JUDY M BAUMGARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PT
Contact information
Practice address
500 SKI HILL, DRIGGS, ID 83422
(208) 354-3128
Mailing address
PO BOX 1612, IDAHO FALLS, ID 83403-1612
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-350
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807140300
—
ID
Enumeration date
11/13/2006
Last updated
06/04/2018
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