Individual
JEREMY BALDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 W JEFFERSON ST APT D, WARSAW, IN 46580-4283
(719) 650-8442
Mailing address
501 W JEFFERSON ST APT D, WARSAW, IN 46580-4283
(719) 650-8442
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003470A
IN
Other
Enumeration date
02/08/2019
Last updated
11/18/2021
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