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General NPI Number Information
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NPI Number | 1891996393
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Entity Type | Individual
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Provider Name | MISS GERMANA NTOYEE BALTOR I
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 141 SW G ST
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City | GRANTS PASS
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State | OR
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Zip | 97526-2413
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Country | US
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Telephone | 541-472-8985
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 SW BETTY LN
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City | GRANTS PASS
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State | OR
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Zip | 97526-5424
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Country | US
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Telephone | 541-472-8985
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 5556
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License Number State | OR
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