Provider Demographics
NPI:1104275601
Name:BAUMANN, LEWIS (PT, OCS)
Entity type:Individual
Prefix:
First Name:LEWIS
Middle Name:
Last Name:BAUMANN
Suffix:
Gender:M
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6160 TUTT BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3500
Mailing Address - Country:US
Mailing Address - Phone:719-596-0880
Mailing Address - Fax:719-596-0899
Practice Address - Street 1:6160 TUTT BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3500
Practice Address - Country:US
Practice Address - Phone:719-596-0880
Practice Address - Fax:719-596-0899
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014023225100000X
CO140232251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist