Physician Compare National (NPI:1871823997)

HEALTHCARE PROVIDER: ASPEN JOY BALTHAZOR DPT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1871823997
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9436314655
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120712000734
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BALTHAZOR
	Individual professional last name
Provider First Name	ASPEN
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1854 W LAKEVIEW CT
	Group Practice or individual's line 1 address
City	HAYSVILLE
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	670605520
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y