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General NPI Number Information
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NPI Number | 1508296641
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Entity Type | Individual
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Provider Name | LAUREN BAKER PT, DPT, ATC, MTC
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Gender | Female
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 1625 S DIVISION AVE
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City | BOISE
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State | ID
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Zip | 83706-3843
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Country | US
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Telephone | 815-545-2738
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Fax |
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Provider Business Mailing Address
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Address Line | 522 W RIVERSIDE AVE STE N
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 815-545-2738
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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 | 15144
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License Number State | WI
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