Individual provider · NPI-1

Dylan Baker

Specialist/Technologist, Athletic Trainer · Saint Louis, MO

NPI number1588058226
StatusActive
Last updated in NPPESMar 19, 2015

Details

NPI
1588058226
Entity type
Individual (NPI-1)
Name
Mr. Dylan Baker
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 19, 2015
Last updated
Mar 19, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes

Practice location

14 Beale St
Saint Louis, MO 63119-1168

Phone 314-581-4856

Mailing address

14 Beale St
Saint Louis, MO 63119-1168

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