Individual
JOEY BAKER
Active
Individual
JOEY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
011312
OH
225100000X
Physical Therapist
2516
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204400
OH MEDICAID UNISON
OH
01
—
000000217253
ANTHEM BCBS
—
01
—
001796085
MOUNTAIN STATE BCBS
—
01
—
2666637
MOLINA MEDICAID
OH
05
—
2666637
—
OH
01
—
310917085167
OH MEDICAID - CARESOURCE
—
05
—
3810004328
—
WV
01
—
P00328954
RR MEDICARE
—
Enumeration date
07/20/2006
Last updated
08/07/2014
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