Individual
NICHOLE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
8204 HIGHWAY 789, LANDER, WY 82520-2941
(307) 335-6731
Mailing address
821 S 7TH ST, LANDER, WY 82520-3603
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-0422
WY
Other
Enumeration date
09/17/2009
Last updated
09/17/2009
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