Individual
MISS TRACIE LAUREN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5620 EAST TEXAS RD, EAST TEXAS (MACUNGIE), PA 18046
(610) 398-7556
Mailing address
558 INTERCHANGE RD, KRESGEVILLE, PA 18333-7721
(570) 688-7273
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG003337
PA
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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