Provider Demographics
NPI:1528228244
Name:BAYLOR, DENISE NICOLE (PT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:NICOLE
Last Name:BAYLOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 DAY BREAK LN
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-2864
Mailing Address - Country:US
Mailing Address - Phone:580-540-4896
Mailing Address - Fax:
Practice Address - Street 1:4609 DAY BREAK LN
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-2864
Practice Address - Country:US
Practice Address - Phone:580-540-4896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist