Individual
MRS. SUSAN JEAN BAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.T.A..
Contact information
Practice address
433 MAIN ST, BROCKWAY, PA 15824-1337
(814) 265-8508
(814) 265-8158
Mailing address
433 MAIN STREET, BROCKWAY, PA 15824
(814) 265-8508
(814) 265-8158
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE1000845
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760421689
NPI
PA
Enumeration date
06/05/2013
Last updated
06/05/2013
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