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1083696967
WALLACE C BAKER
IDAHO FALLS, ID
NPI
1083696967
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID M2619)
Enumeration Date
2005-11-16
Last Update Date
2010-07-19
Business Address
WALLACE C BAKER M.D.
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401-4315
Phone number: 208-524-6633
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Mailing Address
WALLACE C BAKER M.D.
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401-4315
Phone number: 208-524-6633
Copy
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