Individual
ELLYN LEIGH BALTZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.D., L.D./N.
Contact information
Practice address
2601 54TH ST S, GULFPORT, FL 33707-5511
(727) 322-0470
Mailing address
2601 54TH ST S, GULFPORT, FL 33707-5511
(727) 322-0470
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND4122
FL
Other
Enumeration date
05/27/2006
Last updated
07/08/2007
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