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JAMIE ALLEN BAKER MS ATC
Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1114371408
Individual Registrant: JAMIE ALLEN BAKER MS ATC
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1215 D. ST. SALIDA, CO 81201 US
Tel: 740-438-1913 Fax: --
Tel: 740-438-1913 Fax: --
Contact information for business:
1215 D ST SALIDA, CO 81201-2742 US
Tel: 740-438-1913 Fax: --
Tel: 740-438-1913 Fax: --
Registration Information:
NPI: 1114371408
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Athletic Trainer | CO | AT1216 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| NATA BOC | 020002297 | CO | 01 |
| DORA | AT001216 | CO | 01 |
