MEDICARE: POLLY T BAKER-ZITO P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501003252	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700828910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POLLY T BAKER-ZITO P.T.

Provider Business Mailing Address
First Line	:	4466 W BRISTOL RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-3170
Country	:	US
Telephone Number	:	810-733-1200
Fax Number	:	810-733-0688

Provider Business Practice Location Address
First Line	:	17015 SILVER PKWY
Second Line	:
City	:	FENTON
State	:	MI
Zip	:	48430-3425
Country	:	US
Telephone Number	:	810-593-0027
Fax Number	:	810-593-0201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	09/10/2019

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