Individual
DANA E BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
306 E 11TH ST, RUSSELLVILLE, AR 72801-6156
(479) 968-1198
(479) 967-1178
Mailing address
500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
(479) 968-1198
(479) 967-1178
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 3409
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT3409
PT LICENSE
AR
Enumeration date
10/05/2011
Last updated
10/05/2011
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