Individual
MISS JAMIE LYNN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1247 LEE ST, GRANITE CITY, IL 62040-7139
(618) 977-6752
Mailing address
1247 LEE ST, GRANITE CITY, IL 62040-7139
(618) 977-6752
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005708
IL
Other
Enumeration date
06/01/2012
Last updated
06/01/2012
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