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1720866890
CHAD DOUGLAS BAKER
TAHLEQUAH, OK
NPI
1720866890
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2023-09-19
Last Update Date
2023-09-19
Business Address
CHAD DOUGLAS BAKER
118 W KEETOOWAH ST
TAHLEQUAH, OK 74464-3820
Phone number: 918-708-9474
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Mailing Address
CHAD DOUGLAS BAKER
118 W KEETOOWAH ST
TAHLEQUAH, OK 74464-3820
Phone number: 918-708-9474
Copy
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