Individual
JAYME G BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, PT
Contact information
Practice address
875 PERIMETER DR, MOSCOW, ID 83844-9803
(208) 885-1055
Mailing address
424 RYAN LN, MOSCOW, ID 83843-9675
(925) 699-6281
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3457
ID
2255A2300X
Athletic Trainer
Primary
AT-495
ID
Other
Enumeration date
12/02/2011
Last updated
06/21/2024
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