Provider Demographics
NPI:1285707810
Name:BAKER BORSKI CHIROPRACTIC SC
Entity type:Organization
Organization Name:BAKER BORSKI CHIROPRACTIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-675-4106
Mailing Address - Street 1:2809 MERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-1853
Mailing Address - Country:US
Mailing Address - Phone:715-675-4106
Mailing Address - Fax:715-675-4105
Practice Address - Street 1:2809 MERRILL AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-1853
Practice Address - Country:US
Practice Address - Phone:715-675-4106
Practice Address - Fax:715-675-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI676203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000035593Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER