Individual
KELLY ANN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
5100 BRADENTON AVE STE D, DUBLIN, OH 43017
(614) 799-0601
(614) 799-0667
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05009941A
IN
225100000X
Physical Therapist
070019626
IL
225100000X
Physical Therapist
Primary
PT017329
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201055560
—
IN
Enumeration date
05/28/2009
Last updated
05/22/2018
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