Individual
TODD RANDALL BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
114 SMOKETREE WAY, LOUISBURG, NC 27549-2117
(919) 496-6084
Mailing address
3628 NC 39 HWY N, LOUISBURG, NC 27549-6624
(919) 218-6357
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4897
NC
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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