Provider Demographics
NPI:1104680628
Name:MULHERIN, BAKER (DPT)
Entity type:Individual
Prefix:
First Name:BAKER
Middle Name:
Last Name:MULHERIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 SILVER LEAF DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4241
Mailing Address - Country:US
Mailing Address - Phone:615-497-1537
Mailing Address - Fax:
Practice Address - Street 1:275 S MAIN ST STE 208
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6461
Practice Address - Country:US
Practice Address - Phone:303-776-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist