Individual
TIMOTHY DARRELL BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9050 GILBERT RD, RAVENNA, OH 44266-9216
(330) 219-3916
Mailing address
9050 GILBERT RD, RAVENNA, OH 44266-9216
(330) 219-3916
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
Q124289
OH
Other
Enumeration date
05/31/2009
Last updated
05/31/2009
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