Dustin Lee Baker
Technician, Other in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1124472741
StatusActive
Last updated in NPPESJan 17, 2025
Details
- NPI
- 1124472741
- Entity type
- Individual (NPI-1)
- Name
- Dustin Lee Baker
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 20, 2016
- Certification date
- Jan 17, 2025
- Last updated
- Jan 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
1338 Lafayette Ave Ne Apt 1Grand Rapids, MI 49505-5044
Phone 616-204-6813
Mailing address
1338 Lafayette Ave Ne Apt 1Grand Rapids, MI 49505-5044
Phone 616-204-6813
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