Most Relevant Information
Provider Data
| NPI Number: | 1003076530 |
| Provider Name: | STEPHANIE MARIE BAXTER O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 5793 |
Most Important Dates
| Enumeration Date: | 06/09/2008 |
| Last Updated: | 08/17/2015 |
Provider Practice Location
230 E DAY RD
STE 100
MISHAWAKA
IN
465453408
Practice Location Phone/Fax
| Phone: | 5742713939 |
| Fax: | 5742713941 |
Provider Mailing Location
230 E DAY RD
STE 100
MISHAWAKA
IN
465453408
Provider Mailing Phone/Fax
| Phone: | 5742713939 |
| Fax: | 5742713941 |