Basic Information
| Provider Information | |||||||||
| NPI: | 1730103060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAXTER | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | EARL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DSC, OCS, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 CAISSON HILL RD, ATTN: MCXX-CLD-QM (CRED) | ||||||||
| Address2: | IRWIN ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FORT RILEY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664425037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852397155 | ||||||||
| FaxNumber: | 7852397364 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 CAISSON HILL RD, ATTN: MCXX-CLD-QM (CRED) | ||||||||
| Address2: | IRWIN ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FORT RILEY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664425037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852397155 | ||||||||
| FaxNumber: | 7852397364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 140842 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.