Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CHIR007434 | GA |
NPI | 1063552503 |
---|---|
Provider Name | Dr. Elizabeth Baker |
First Address | Acworth, GA 30101-3942 |
Second Address | Acworth, GA 30101-9532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |