MEDICARE: DEBBY BAKER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4060	AZ

General Provider Information

NPI Number	:	1114920659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBY BAKER D.C.

Provider Business Mailing Address
First Line	:	5128 W PEORIA AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-1618
Country	:	US
Telephone Number	:	623-878-0600
Fax Number	:	623-878-0623

Provider Business Practice Location Address
First Line	:	5128 W PEORIA AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-1618
Country	:	US
Telephone Number	:	623-878-0600
Fax Number	:	623-878-0623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2005
Last Update Date	:	07/08/2007

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