Individual
DR. PHILLIP M BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
412 MAIN ST, LONGMONT, CO 80501-5535
(303) 651-6700
Mailing address
947 CHAMPION CIR, LONGMONT, CO 80503-3668
(303) 772-3980
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
915
CO
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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