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General NPI Number Information
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NPI Number | 1326124694
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Entity Type | Organization
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Legal Business Name | ALAN L BALKANSKY DPMSC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 5404A N LOVERS LANE RD
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City | MILWAUKEE
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State | WI
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Zip | 53225-3006
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Country | US
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Telephone | 414-442-3400
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Fax | 414-442-0344
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Provider Business Mailing Address
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Address Line | 5404A N LOVERS LANE RD
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City | MILWAUKEE
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State | WI
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Zip | 53225-3006
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Country | US
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Telephone | 414-442-3400
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Fax | 414-442-0344
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Authorized Official
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Title or Position | PRESIDENT PODIATRIST
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Name | DR. ALAN L BALKANSKY
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Credential | DPM
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Telephone | 414-442-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 429025
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License Number State | WI
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