Provider Demographics
NPI:1790827319
Name:BAKER, CAROL LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LYNN
Last Name:BAKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 TAYLOR BRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-7109
Mailing Address - Country:US
Mailing Address - Phone:423-753-2952
Mailing Address - Fax:
Practice Address - Street 1:301 TAYLOR BRIDGE RD
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-7109
Practice Address - Country:US
Practice Address - Phone:423-753-2952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHO0002896111N00000X
TN2357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor