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1861483562
CLINTON W BAKER
FRUITLAND, ID
NPI
1861483562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-454)
Enumeration Date
2005-11-02
Last Update Date
2019-07-29
Business Address
CLINTON W BAKER PA-C
1210 NW 16TH ST
FRUITLAND, ID 83619-2202
Phone number: 208-452-8600
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Mailing Address
CLINTON W BAKER PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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