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1124587076
LUCAS BAKER
MORGANTOWN, WV
NPI
1124587076
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WV 2000028601)
Enumeration Date
2019-03-19
Last Update Date
2019-03-19
Business Address
LUCAS BAKER
943 MAPLE DR
MORGANTOWN, WV 26505-2812
Phone number: 304-599-2515
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Mailing Address
LUCAS BAKER
5466 IRADELL RD
ITHACA, NY 14850-9257
Phone number: 607-387-5893
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