Provider Demographics
NPI:1003006453
Name:BAKER FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:BAKER FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WAISBROT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-697-1800
Mailing Address - Street 1:10494 LOVELAND MADEIRA RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-9338
Mailing Address - Country:US
Mailing Address - Phone:513-697-1800
Mailing Address - Fax:513-697-1888
Practice Address - Street 1:10494 LOVELAND MADEIRA RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-9338
Practice Address - Country:US
Practice Address - Phone:513-697-1800
Practice Address - Fax:513-697-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0828103Medicare PIN