Individual
LANE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA, CLT
Contact information
Practice address
3131 TOM AUSTIN HIGHWAY, SPRINGFIELD, TN 37172
(615) 382-7979
Mailing address
3131 TOM AUSTIN HWY, SPRINGFIELD, TN 37172-4801
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
98214844202
UT
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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