Provider Demographics
NPI:1306301650
Name:BAKER, ASHLEY (BS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:BS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4885 BRADDOCK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-8019
Mailing Address - Country:US
Mailing Address - Phone:714-873-8749
Mailing Address - Fax:
Practice Address - Street 1:4885 BRADDOCK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8019
Practice Address - Country:US
Practice Address - Phone:714-873-8749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty