Provider Demographics
NPI:1861702466
Name:BAKER, KENNETH CHARLES JR (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:CHARLES
Last Name:BAKER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:725 MUMPER LN
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-9310
Mailing Address - Country:US
Mailing Address - Phone:570-772-2225
Mailing Address - Fax:717-820-2990
Practice Address - Street 1:156 CUMBERLAND PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6694
Practice Address - Country:US
Practice Address - Phone:717-820-2998
Practice Address - Fax:717-820-2990
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADC010331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor