Individual
MR. NATHANIEL BAKER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 W 1ST ST, WINSTON SALEM, NC 27104-4220
(704) 701-3309
Mailing address
28 BEAUREGARD DR, SPENCER, NC 28159-1956
(704) 701-3309
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6578
NC
Other
Enumeration date
03/29/2019
Last updated
03/29/2019
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