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1104401108
IZAIAH BAKER
CHARLESTON, WV
NPI
1104401108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2021-03-11
Last Update Date
2021-03-11
Business Address
IZAIAH BAKER
5303 KANAWHA AVE SE
CHARLESTON, WV 25304-2215
Phone number: 304-881-6570
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Mailing Address
IZAIAH BAKER
5303 KANAWHA AVE SE
CHARLESTON, WV 25304-2215
Phone number: 304-881-6570
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