Travis Baker
Technician, Other in Jackson, MI. Individual provider (NPI-1).
NPI number1164023651
StatusActive
Last updated in NPPESNov 3, 2020
Details
- NPI
- 1164023651
- Entity type
- Individual (NPI-1)
- Name
- Travis Baker
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 3, 2020
- Certification date
- Nov 3, 2020
- Last updated
- Nov 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
1001 Laurence Ave Ste EJackson, MI 49202-2980
Phone 517-750-4777
Mailing address
3022 Nevada DrJackson, MI 49201-9023
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