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1376285767
ELDRIDGE E BALTAZAR
FORT BRAGG, NC
NPI
1376285767
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NC 2397)
Enumeration Date
2022-04-07
Last Update Date
2022-07-27
Business Address
Mr. ELDRIDGE E BALTAZAR L/ATC
2416 KEERANS ST 82ND 3BCT
FORT BRAGG, NC 28310-7243
Phone number: 910-984-9119
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Mailing Address
Mr. ELDRIDGE E BALTAZAR L/ATC
206 STOBHILL LN
HOLLY SPRINGS, NC 27540-7243
Phone number: 910-297-2115
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