Provider Demographics
NPI:1699596601
Name:BAKER, TAYLOR (MA, LAT, ATC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NC
Mailing Address - Zip Code:28127-8551
Mailing Address - Country:US
Mailing Address - Phone:910-334-9597
Mailing Address - Fax:
Practice Address - Street 1:175 SAINT LUKES CHURCH RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-8222
Practice Address - Country:US
Practice Address - Phone:910-334-9597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-44602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer