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General NPI Number Information
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NPI Number | 1326317504
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Entity Type | Organization
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Legal Business Name | BALANCE PROSTHETICS AND ORTHOTICS INC
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Dates
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Enumeration Date | 12/18/2011
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 3601 CHICHESTER AVE SUITE 108
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City | UPPER CHICHESTER
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State | PA
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Zip | 19061-3149
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Country | US
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Telephone | 484-489-1006
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Fax | 484-489-1001
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Provider Business Mailing Address
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Address Line | 3601 CHICHESTER AVE SUITE 108
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City | UPPER CHICHESTER
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State | PA
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Zip | 19061-3149
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Country | US
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Telephone | 484-489-1006
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Fax | 484-489-1001
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER MICHALOWSKI
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Credential |
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Telephone | 215-300-8873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | CPO01938
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License Number State | VA
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