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Individual

JEFFERY ROBERT BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LAT, ATC

Contact information

Practice address
1 CHAMPIONS DR SUITE 200, COLUMBIA, MO 65211-6505
(573) 239-8756
Mailing address
1 CHAMPIONS DR SUITE 200, COLUMBIA, MO 65211-0001
(573) 239-8756

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2020035276
MO

Other

Enumeration date
02/11/2015
Last updated
11/15/2022
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