Healthcare Provider Details
I. General information
NPI: 1780341065
Provider Name (Legal Business Name): BAKER O & P ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2021
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
519 BRYAN ST
DENTON TX
76201-2705
US
IV. Provider business mailing address
102 WOODMONT BLVD STE 120
NASHVILLE TN
37205-5249
US
V. Phone/Fax
- Phone: 940-800-2990
- Fax:
- Phone: 615-864-8790
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
KRATOHVIL
Title or Position: VP OF FINANCE, CONTROLLER
Credential:
Phone: 615-550-8760