Individual
LISA MICHELLE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
606 N JEFFERSON ST, UTICA, OH 43080-9700
(740) 405-4998
Mailing address
PO BOX 938, UTICA, OH 43080-0938
(740) 405-4998
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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