Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1124682588 |
---|---|
Provider Name | Julie A Baker |
First Address | Tucson, AZ 85719-5966 |
Second Address | Tucson, AZ 85712-2137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2019 |
Last Update Date | 30/04/2019 |