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General NPI Number Information
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NPI Number | 1811135775
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Entity Type | Individual
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Provider Name | ANTHONY FRANK BALCERZAK OWNER
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Gender | Male
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Dates
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Enumeration Date | 01/30/2009
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 38516 N GRATIOT AVENUE
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City | CLINTON TWP
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State | MI
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Zip | 48036
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Country | US
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Telephone | 586-463-8801
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Fax | 586-463-8804
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Provider Business Mailing Address
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Address Line | 38516 N GRATIOT AVENUE
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City | CLINTON TWP,MI, 48036
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State | MI
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Zip | 48047
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Country | US
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Telephone | 586-463-8801
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Fax | 586-463-8804
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225CX0006X
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Taxonomy Name | Orientation and Mobility Training Rehabilitation Counselor
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License Number | B203734287
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License Number State | MI
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