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Individual

ANGIE PRUITT BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
8072 NORMANDY DR, FORT RILEY, KS 66442-7069
(785) 240-5516
(785) 239-4065
Mailing address
1509 LITTLE KITTEN AVE, MANHATTAN, KS 66503-7578
(785) 313-2796

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2466
OK

Other

Enumeration date
10/13/2005
Last updated
02/11/2021
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