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General NPI Number Information
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NPI Number | 1245443415
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Entity Type | Organization
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Legal Business Name | JON BAKER CHIROPRACTIC CORP
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2150 SCENIC DR
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City | MODESTO
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State | CA
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Zip | 95355-4402
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Country | US
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Telephone | 209-527-8560
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Fax | 209-527-0837
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Provider Business Mailing Address
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Address Line | 2150 SCENIC DR
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City | MODESTO
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State | CA
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Zip | 95355-4402
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Country | US
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Telephone | 209-527-8560
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Fax | 209-527-0837
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Authorized Official
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Title or Position | OWNER
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Name | DR. JON PAUL BAKER
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Credential | DC
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Telephone | 209-527-8560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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