Individual
JOHN BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4600 E SHEA BLVD, SUITE 101, PHOENIX, AZ 85028-6024
(602) 368-8601
Mailing address
18518 W VALERIE DR, SURPRISE, AZ 85374-3902
(218) 205-6595
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5793
AZ
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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