Individual
JACOB BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1297
(304) 388-4600
(304) 388-4621
Mailing address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1297
(304) 388-4600
(304) 388-4621
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/21/2022
Last updated
05/21/2022
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