Provider Demographics
NPI:1124682588
Name:BAKER, JULIE A (MSPT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:BASKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1830 E BROADWAY BLVD STE 124-316
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-5966
Mailing Address - Country:US
Mailing Address - Phone:520-232-2553
Mailing Address - Fax:520-232-2553
Practice Address - Street 1:2260 N ROSEMONT BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2137
Practice Address - Country:US
Practice Address - Phone:520-232-2021
Practice Address - Fax:520-232-2553
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics