Provider Demographics
NPI:1891996393
Name:BALTOR, GERMANA NTOYEE I
Entity Type:Individual
Prefix:MISS
First Name:GERMANA
Middle Name:NTOYEE
Last Name:BALTOR
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 SW BETTY LN
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-5424
Mailing Address - Country:US
Mailing Address - Phone:541-472-8985
Mailing Address - Fax:
Practice Address - Street 1:141 SW G ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2413
Practice Address - Country:US
Practice Address - Phone:541-472-8985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
OR5556225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist