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Individual

KYLE ANDRE JULIO BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
11239 PEARTREE WAY, APT. I, COLUMBIA, MD 21044-4342
(443) 253-6383
(443) 864-4633
Mailing address
11239 PEARTREE WAY, APT. I, COLUMBIA, MD 21044-4342
(443) 253-6383
(443) 864-4633

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT1343
DC
225700000X
Massage Therapist
R01515
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02109549
ADVENTIST RISK MGMT, INC.
PA
Enumeration date
01/06/2012
Last updated
01/06/2012
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