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General NPI Number Information
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NPI Number | 1417575135
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Entity Type | Individual
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Provider Name | AIMEE CARRON BAKER PT
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Gender | Female
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 1120 E LONG LAKE RD STE 201
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City | TROY
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State | MI
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Zip | 48085-4716
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Country | US
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Telephone | 248-496-0098
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Fax |
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Provider Business Mailing Address
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Address Line | 9596 DOLORES
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City | CLARKSTON
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State | MI
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Zip | 48348-2400
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Country | US
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Telephone | 248-891-8445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501002616
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License Number State | MI
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