Provider Demographics
NPI:1962798777
Name:BAKER CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BAKER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-333-4641
Mailing Address - Street 1:412 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:KY
Mailing Address - Zip Code:42459-1630
Mailing Address - Country:US
Mailing Address - Phone:270-333-4641
Mailing Address - Fax:270-333-4641
Practice Address - Street 1:412 N MAIN ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:KY
Practice Address - Zip Code:42459-1630
Practice Address - Country:US
Practice Address - Phone:270-333-4641
Practice Address - Fax:270-333-4641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5293111N00000X
KY5292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty