Basic Information
Provider Information
NPI: 1952418196
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAHR
FirstName: ROBERT
MiddleName: JOHN
NamePrefix: MR.
NameSuffix:  
Credential: PHYSICAL THERAPIST
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5931 WOODFIELD ESTATES DR
Address2:  
City: ALEXANDRIA
State: VA
PostalCode: 223101895
CountryCode: US
TelephoneNumber: 7039223833
FaxNumber:  
Practice Location
Address1: 6900 GEORGIA AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 203070003
CountryCode: US
TelephoneNumber: 2027826371
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/24/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X14446MDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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