Provider Demographics
NPI:1982967253
Name:BAKER, ERIC (PTA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-7449
Mailing Address - Country:US
Mailing Address - Phone:828-781-9853
Mailing Address - Fax:
Practice Address - Street 1:438 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-7449
Practice Address - Country:US
Practice Address - Phone:828-781-9853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA3453225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant