Individual
JESSICA BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3681 LEAPHART RD STE A, WEST COLUMBIA, SC 29169-3068
(803) 454-6090
(803) 454-6090
Mailing address
3681 LEAPHART RD STE A, WEST COLUMBIA, SC 29169-3068
(803) 454-6090
(803) 454-6090
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2457
SC
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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