Most Relevant Information
Provider Data
| NPI Number: | 1003226465 |
| Provider Name: | HERON BAUMGARTEN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/06/2014 |
| Last Updated: | 08/25/2021 |
Provider Practice Location
231 E CHESTNUT ST
LOUISVILLE
KY
402021821
Practice Location Phone/Fax
| Phone: | 5025880390 |
| Fax: | 5025880396 |
Provider Mailing Location
PO BOX 776879
CHICAGO
IL
606776879
Provider Mailing Phone/Fax
| Phone: | 5025889490 |
| Fax: | 5022725116 |