Individual
MR. ANTHONY JOHN BALTIERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
Mailing address
223 MEADOW DR, ORANGEVILLE, IL 61060-9218
(815) 541-8214
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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