Provider Demographics
NPI:1124789433
Name:BAKER, BROOKE CORINE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:CORINE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1293
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-0001
Mailing Address - Country:US
Mailing Address - Phone:830-717-9390
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1293
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133-0001
Practice Address - Country:US
Practice Address - Phone:830-717-9390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-08
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist