Provider Demographics
NPI:1528697414
Name:BAUER, ELIZABETH ALLISON (PT, DPT, CLT-LANA)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ALLISON
Last Name:BAUER
Suffix:
Gender:F
Credentials:PT, DPT, CLT-LANA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 N LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5609
Mailing Address - Country:US
Mailing Address - Phone:719-201-2956
Mailing Address - Fax:
Practice Address - Street 1:175 S UNION BLVD STE 245
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3125
Practice Address - Country:US
Practice Address - Phone:719-365-1752
Practice Address - Fax:719-365-6821
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0644208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation