Most Relevant Information
Provider Data
| NPI Number: | 1003549478 |
| Provider Name: | TIA BAKKER |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/05/2022 |
| Last Updated: | 07/05/2022 |
Provider Practice Location
248 SHERMAN LN
BIGFORK
MT
599116057
Practice Location Phone/Fax
| Phone: | 4062601072 |
| Fax: |
Provider Mailing Location
248 SHERMAN LN
BIGFORK
MT
599116057
Provider Mailing Phone/Fax
| Phone: | 4062601072 |
| Fax: |