Eric Baker, PTA

Individual provider Active NPI Physical Therapy Assistant · Renovo, PA

NPI 1679115802 · NPPES record last updated Oct 9, 2019

Key facts

NPI
1679115802
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
TEI004683 (PA)
Practice address
1001 Pine St
Renovo, PA 17764-1620
Phone
(570) 923-1000
NPI assigned
Oct 9, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
TEI004683PAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TEI004683 PA Yes

Addresses

Primary practice location

1001 Pine St
Renovo, PA 17764-1620

Mailing address

9777 Charger Hwy
Duncansville, PA 16635-5049

Other providers in Renovo, PA

All providers in Renovo, PA · Physical Therapy Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.