Provider Demographics
NPI:1952363418
Name:BAKER, ROBIN L (DC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:BAKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:L
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2809 MERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-1853
Mailing Address - Country:US
Mailing Address - Phone:715-675-4106
Mailing Address - Fax:715-675-4105
Practice Address - Street 1:2809 MERRILL AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-1853
Practice Address - Country:US
Practice Address - Phone:715-675-4106
Practice Address - Fax:715-675-4105
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3289-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38900800Medicaid
WI0000135593Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
WI38900800Medicaid