Provider Demographics
NPI:1891785002
Name:BAKER, BRIAN C (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:BAKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 REEF RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5922
Mailing Address - Country:US
Mailing Address - Phone:203-259-4939
Mailing Address - Fax:203-259-3793
Practice Address - Street 1:133 REEF RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5922
Practice Address - Country:US
Practice Address - Phone:203-259-4939
Practice Address - Fax:203-259-3793
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00582CT111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic