Individual
DALE BALTRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3101 S GLENSTONE AVE, SPRINGFIELD, MO 65804-4403
(417) 883-7598
Mailing address
4536 E PEARSON MEADOW DR, SPRINGFIELD, MO 65802-6242
(417) 204-9825
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
3064
MT
183500000X
Pharmacist
Primary
42407
MO
Other
Enumeration date
04/10/2010
Last updated
04/10/2010
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