Provider Demographics
NPI:1407530371
Name:BAKER, KAYLIE RAE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KAYLIE
Middle Name:RAE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 TIMBER RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-2241
Mailing Address - Country:US
Mailing Address - Phone:419-566-6108
Mailing Address - Fax:
Practice Address - Street 1:795 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NH
Practice Address - Zip Code:03870-2318
Practice Address - Country:US
Practice Address - Phone:039-648-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT020520225100000X
NHPT020520225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist