Provider Demographics
NPI:1508953068
Name:BAKER, ELIZABETH WILSON (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:WILSON
Last Name:BAKER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ROWLAND
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:920 ARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MTN.
Mailing Address - State:TN
Mailing Address - Zip Code:37377
Mailing Address - Country:US
Mailing Address - Phone:423-309-4484
Mailing Address - Fax:423-892-5628
Practice Address - Street 1:2021 HAMILTON PLACE BLVD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6046
Practice Address - Country:US
Practice Address - Phone:423-855-9285
Practice Address - Fax:423-892-5628
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist