Individual
DUSTIN KYLE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
622-692 10TH ST SW, BIRMINGHAM, AL 35211
(205) 783-3292
Mailing address
1306 ELDERBERRY ST, PELL CITY, AL 35128-7345
(205) 516-2842
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5746
AL
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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