| Kevin Baerwalde, PT | |
|
302 S Greenwood St, Lagrange, GA 30240-3122 | |
| (706) 884-8360 | |
| (706) 884-0265 |
| Full Name | Kevin Baerwalde |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 302 S Greenwood St, Lagrange, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326034471 | NPI | - | NPPES |
| 611446156001 | Other | GA | TRICARE-FITNESS FORUM |
| 393730 | Other | GA | BCBS OF GA |
| 65BBCKQ | Other | GA | MEDICARE PIN-FITNESS FORUM |
| 112003 | Other | GA | BCBS-FITNESS FORUM |
| 52793122-002 | Other | GA | BCBS ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | LIC006138 (Georgia) | Primary |
| Provider Name | Certified Rehab Of Georgia |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1598840282 PECOS PAC ID: 2163404609 Enrollment ID: O20040607001050 |
| Provider Name | Wellstar Health Ventures, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1932486131 PECOS PAC ID: 1456527878 Enrollment ID: O20120105000563 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Baerwalde, PT 302 S Greenwood St, Lagrange, GA 30240-3122 Ph: (706) 884-8360 | Kevin Baerwalde, PT 302 S Greenwood St, Lagrange, GA 30240-3122 Ph: (706) 884-8360 |
Dr. Joshua Young Davis, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1514 Vernon Rd, Lagrange, GA 30240 Phone: 706-845-3677 Fax: 706-845-3700 | |
Joanne Robben, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1805 Vernon Rd, Suite A, Lagrange, GA 30240 Phone: 706-845-9383 Fax: 706-845-9482 | |
Mrs. Haley Alicia Egesdahl, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1805 Vernon Rd, Ste A, Lagrange, GA 30240 Phone: 706-845-9383 Fax: 706-845-9482 | |
Mr. Timothy Eugene Moore, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 107 Calumet Center Rd, Lagrange, GA 30241 Phone: 706-884-3274 Fax: 706-882-2940 | |
Amy Purdy, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1075 Lafayette Pkwy, Lagrange, GA 30241 Phone: 706-350-1338 | |
David J Buuck, PT DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1805 Vernon Rd Ste A, Lagrange, GA 30240 Phone: 706-845-9383 |