Individual
JEFF BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
534 TOWN ST, MOODUS, CT 06469-1101
(860) 873-6547
Mailing address
534 TOWN ST, MOODUS, CT 06469-1101
(860) 873-6547
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006230
CT
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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