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Individual

AL BALTRUSAITIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3021 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 496-4700
Mailing address
3021 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
24456
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30018600
WI
Enumeration date
02/07/2006
Last updated
04/05/2010
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