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General NPI Number Information
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NPI Number | 1932104742
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Entity Type | Individual
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Provider Name | JOHN BALKO MD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 102 N KEEL RIDGE RD
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City | HERMITAGE
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State | PA
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Zip | 16148-3440
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Country | US
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Telephone | 866-758-4862
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Fax | 330-758-4886
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Provider Business Mailing Address
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Address Line | 102 N KEEL RIDGE RD
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City | HERMITAGE
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State | PA
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Zip | 16148-3440
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Country | US
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Telephone | 866-758-4862
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Fax | 330-758-4886
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | SL001837L
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License Number State | OH
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