Individual
JEREMY BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
441 WADSWORTH BLVD STE 105A, LAKEWOOD, CO 80226-1545
(720) 670-6888
Mailing address
12865 W ALAMEDA DR, LAKEWOOD, CO 80228-2826
(720) 670-6888
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0012979
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT.0012979
MASSAGE LICENCE
CO
Enumeration date
04/29/2015
Last updated
04/29/2015
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