KRISTIN MARIE BALTHAZOR PA-C, MPAS
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1649422619- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA-C, MPAS
- Status
- Active
Contact & Location
- Address
- 2124 KOHLER MEMORIAL DR, SHEBOYGAN, WI, 530813169
- Phone
- (833) 821-7246
Specialties & Taxonomies
Physician Assistant
License: IL #085.003246
Physician Assistant
Primary License: WI #4402-23