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Individual

TINA LYNN BAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, ATC, CLT

Contact information

Practice address
7250 PEAK DR, SUITE 118, LAS VEGAS, NV 89128-9027
(702) 877-2000
(702) 877-2100
Mailing address
PO BOX 34797, LAS VEGAS, NV 89133-4797
(702) 877-2000
(702) 877-2100

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1204
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CC2342
BLUE CROSS BLUE SHIELD
NV
Enumeration date
07/07/2005
Last updated
11/08/2011
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