Individual
ZACHARY TYLER BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
610 N MISSOURI ST, WEST MEMPHIS, AR 72301-3148
(870) 400-0179
Mailing address
610 N MISSOURI ST, WEST MEMPHIS, AR 72301-3148
(870) 400-0179
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1906
AR
Other
Enumeration date
10/07/2022
Last updated
02/15/2023
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