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Individual

MARYCAROL BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, CKTP, CCI

Contact information

Practice address
210 FERRY WAY, JUNEAU, AK 99801-1389
(314) 541-7902
(573) 803-0742
Mailing address
1556 LEXINGTON AVE, CAPE GIRARDEAU, MO 63701-2528
(314) 541-7902

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070003083
IL
225100000X
Physical Therapist
Primary
2004025487
MO
225100000X
Physical Therapist
2398
AK
225100000X
Physical Therapist
P13507
NC
225100000X
Physical Therapist
RPT-344
ID

Other

Enumeration date
08/12/2010
Last updated
07/19/2012
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