Provider Demographics
NPI:1588970255
Name:BAKER, CAROL P (PT)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:P
Last Name:BAKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:PFIZENMAIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:104 GAINESBOROUGH DR APT 1805
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-7257
Mailing Address - Country:US
Mailing Address - Phone:914-772-5971
Mailing Address - Fax:
Practice Address - Street 1:2014 BEES FERRY RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-6603
Practice Address - Country:US
Practice Address - Phone:843-556-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007104-1225100000X
SC7675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist