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1215130828
RUSSELL THOMAS BAKER
RIVERSIDE, CA
NPI
1215130828
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2007-06-09
Last Update Date
2009-12-02
Business Address
Mr. RUSSELL THOMAS BAKER MS, MS, ATC
8432 MAGNOLIA AVE
RIVERSIDE, CA 92504-3206
Phone number: 239-560-7854
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Mailing Address
Mr. RUSSELL THOMAS BAKER MS, MS, ATC
7450 NORTHROP DR APT 94
RIVERSIDE, CA 92508-5005
Phone number: 239-560-7854
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