Provider Demographics
NPI:1528485554
Name:BAKER, VICKI (PT)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:
Other - Last Name:HITCHCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6604 KIVA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-8986
Mailing Address - Country:US
Mailing Address - Phone:303-815-7587
Mailing Address - Fax:970-532-5450
Practice Address - Street 1:6604 KIVA RIDGE DR
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-8986
Practice Address - Country:US
Practice Address - Phone:303-815-7587
Practice Address - Fax:970-532-5450
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0010790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist