Individual
MRS. MAE BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1201 US HWY 10 W, UNIT E, LIVINGSTON, MT 59047
(406) 222-5519
(406) 222-0366
Mailing address
1201 US HWY 10 W, UNIT E, LIVINGSTON, MT 59047
(406) 222-5519
(406) 222-0366
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA01208200
NJ
Other
Enumeration date
09/11/2007
Last updated
05/19/2011
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