Provider Demographics
NPI:1982631529
Name:BAKER, LONNIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LONNIE
Middle Name:
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:PO BOX 657
Mailing Address - Street 2:
Mailing Address - City:LACYGNE
Mailing Address - State:KS
Mailing Address - Zip Code:66040
Mailing Address - Country:US
Mailing Address - Phone:913-757-3600
Mailing Address - Fax:913-757-3616
Practice Address - Street 1:121 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LACYGNE
Practice Address - State:KS
Practice Address - Zip Code:66040-4071
Practice Address - Country:US
Practice Address - Phone:913-757-3600
Practice Address - Fax:913-757-3616
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor