Individual
ANNA MAKENZIE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
211 LOVE AVE, TIFTON, GA 31794-4453
(229) 382-9751
Mailing address
1323 4TH ST SW, MOULTRIE, GA 31768-5818
(229) 873-1274
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002889
GA
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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