Individual
MS. EDITA C BALTASAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, RD, LD
Contact information
Practice address
729 HAMLET CIR, YUKON, OK 73099-4401
(405) 826-2023
(405) 354-1073
Mailing address
PO BOX 850894, YUKON, OK 73085-0894
(405) 826-2023
(405) 354-1073
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD 222
OK
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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