Individual
JASON L BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2611 S BANKER ST, EFFINGHAM, IL 62401-2980
(217) 342-6002
(217) 342-6211
Mailing address
15 APEX DR, HIGHLAND, IL 62249-1282
(618) 651-0444
(618) 654-5439
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056005920
IL
Other
Enumeration date
07/06/2006
Last updated
09/16/2007
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