Provider Demographics
NPI:1386365625
Name:BAUGHMAN, ZACHERY ALLEN
Entity type:Individual
Prefix:
First Name:ZACHERY
Middle Name:ALLEN
Last Name:BAUGHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 RAYMILTON RD
Mailing Address - Street 2:
Mailing Address - City:POLK
Mailing Address - State:PA
Mailing Address - Zip Code:16342-3332
Mailing Address - Country:US
Mailing Address - Phone:181-422-9965
Mailing Address - Fax:
Practice Address - Street 1:1322 RAYMILTON RD
Practice Address - Street 2:
Practice Address - City:POLK
Practice Address - State:PA
Practice Address - Zip Code:16342-3332
Practice Address - Country:US
Practice Address - Phone:814-229-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer