Individual
LYNETTE BALTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7901 DILEY RD STE 260, CANAL WINCHESTER, OH 43110-9613
(614) 920-1000
Mailing address
7901 DILEY RD STE 260, CANAL WINCHESTER, OH 43110-9613
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.003312
OH
363AM0700X
Medical Physician Assistant
PA00046
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01903811
—
MS
Enumeration date
03/14/2006
Last updated
03/17/2018
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