Individual
JORDAN COLEMAN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
840 N 87TH ST, MILWAUKEE, WI 53226-3586
(208) 569-5265
Mailing address
840 N 87TH ST, MILWAUKEE, WI 53226-3586
(208) 569-5265
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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