Individual
DYLAN JORDAN BALTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
430 NE 10TH ST, GAINESVILLE, FL 32601-5688
(954) 496-3110
Mailing address
430 NE 10TH ST, GAINESVILLE, FL 32601-5688
(954) 496-3110
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
31008
FL
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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