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Individual

JAMIE ALLEN BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS ATC

Contact information

Practice address
1215 D. ST., SALIDA, CO 81201
(740) 438-1913
Mailing address
1215 D ST, SALIDA, CO 81201-2742
(740) 438-1913

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1216
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020002297
NATA BOC
CO
01
AT001216
DORA
CO
Enumeration date
04/22/2016
Last updated
04/22/2016
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