Doctor Name: | KYLE ANDRE JULIO BAKER |
NPI Number: | 1144590217 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT |
License Number: | R01515 |
Business Practice Address: | 11239 Peartree Way Apt. I Columbia, MD - 210444342 |
Business Phone Number: | 4432536383 |
Business Fax Number: | 4438644633 |
Mailing Address: | 11239 Peartree Way, Apt. I COLUMBIA |
State: | MD |
Postal Code: | 210444342 |
Phone Number: | 4432536383 |
Fax Number: | 4438644633 |
NPI Enumeration Date: | 01/06/2012 |
NPI Last Update Date: | 01/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | R01515 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |