Individual
MR. ELDRIDGE E BALTAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L/ATC
Contact information
Practice address
2416 KEERANS ST 82ND 3BCT, FORT BRAGG, NC 28310-7243
(910) 984-9119
Mailing address
206 STOBHILL LN, HOLLY SPRINGS, NC 27540-7243
(910) 297-2115
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2397
NC
Other
Enumeration date
04/07/2022
Last updated
07/27/2022
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