Provider Demographics
NPI:1093954893
Name:BAKER, BRETT (DC)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21321 E OCOTILLO RD STE C108
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-7585
Mailing Address - Country:US
Mailing Address - Phone:480-677-2800
Mailing Address - Fax:888-503-3238
Practice Address - Street 1:21321 E OCOTILLO RD STE C108
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-7585
Practice Address - Country:US
Practice Address - Phone:480-677-2800
Practice Address - Fax:888-503-3238
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor