Provider Demographics
NPI:1235327222
Name:BAKER, KATHRYN H
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:H
Last Name:BAKER
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 1:101 E 6TH ST
Mailing Address - Street 2:P.O. BOX 1506
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1201
Mailing Address - Country:US
Mailing Address - Phone:814-459-2755
Mailing Address - Fax:814-456-4873
Practice Address - Street 1:101 E 6TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1201
Practice Address - Country:US
Practice Address - Phone:814-459-2755
Practice Address - Fax:814-456-4873
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist