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Individual

MRS. CHANTELL CORDELL BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
600 22ND ST NW, WASHINGTON, DC 20052-0055
(202) 994-5779
Mailing address
4918 ASHBY ST NW, WASHINGTON, DC 20007-1045
(907) 947-7017

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000017359

Other

Enumeration date
04/28/2017
Last updated
04/28/2017
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