Individual provider · NPI-1

Tiffany Baldwin

Specialist/Technologist, Athletic Trainer · Saint Louis, MO

NPI number1356798508
StatusActive
Last updated in NPPESMay 18, 2016

Details

NPI
1356798508
Entity type
Individual (NPI-1)
Name
Tiffany Baldwin
Sex
Female
Sole proprietor
No
Enumeration date
May 18, 2016
Last updated
May 18, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer2015025520MOYes

Practice location

655 Craig Rd Ste 160
Saint Louis, MO 63141-7173

Phone 314-305-1407

Mailing address

522 Rifle Ridge Dr
O Fallon, MO 63366-4858

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