Balthazor, Miles

Balthazor, Miles is an individual health care provider with primary practice located at 1715 S Baltimore Ave , Tulsa OK 74119-4807. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Electroneurodiagnostic, which is considered as his primary health care specialty. Balthazor, Miles can be contacted via phone (918) 895-7680.

Contact Information

Primary practice address
1715 S Baltimore Ave Tulsa OK 74119-4807
Phone: (918) 895-7680
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Electroneurodiagnostic 246ZE0600X

Profile Details

NPI number 1518695121
LBN Legal business name Balthazor, Miles
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2022
Last updated Aug 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1518695121 NPPES
Missouri Other 11011995 DOB

Popular Providers