Individual
ROY JACKSON BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
521 ROWE LN, COLORADO SPRINGS, CO 80911-2624
(719) 213-8531
Mailing address
5360 N ACADEMY BLVD, COLORADO SPRINGS, CO 80918-4006
(719) 434-2016
(719) 434-2275
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0043255
CO
Other
Enumeration date
11/16/2018
Last updated
11/16/2018
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