=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922053743
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAKER CHIROPRACTIC & REHABILITATION, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2006
-----------------------------------------------------
Last Update Date | 04/28/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 305 CAMP HOLLOW RD
-----------------------------------------------------
City | WEST MIFFLIN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15122-2604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-469-9600
-----------------------------------------------------
Fax | 412-469-9901
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 305 CAMP HOLLOW RD
-----------------------------------------------------
City | WEST MIFFLIN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15122-2604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-469-9600
-----------------------------------------------------
Fax | 412-469-9901
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | DR. JOANNA LOUISE BAKER
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 412-469-9600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC007555-L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------