Provider Demographics
NPI:1073772695
Name:BAKER-MARSH, KAYE
Entity Type:Individual
Prefix:MRS
First Name:KAYE
Middle Name:
Last Name:BAKER-MARSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 WOODGLEN LN
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-7514
Mailing Address - Country:US
Mailing Address - Phone:803-422-3458
Mailing Address - Fax:
Practice Address - Street 1:112 WOODGLEN LN
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-7514
Practice Address - Country:US
Practice Address - Phone:803-422-3458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC658225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist