Individual
AYRES BALTZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSOTR/L
Contact information
Practice address
517 CLAY ST, HENDERSON, KY 42420-3623
(812) 449-3652
Mailing address
517 CLAY ST, HENDERSON, KY 42420-3623
(812) 449-3652
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31005009A
IN
225X00000X
Occupational Therapist
Primary
R4352
KY
Other
Enumeration date
09/14/2009
Last updated
02/16/2012
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