Individual
BREANNA ANGELA BALTRUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO, LPO
Contact information
Practice address
2515 N CLARK ST STE 802, CHICAGO, IL 60614-2730
(312) 227-6210
Mailing address
225 E CHICAGO AVE # 46, CHICAGO, IL 60611-2991
(312) 227-6210
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
213.000402
IL
224P00000X
Prosthetist
211.000354
IL
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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