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NPI Code Detail

MEDICARE: JOSEPH BALCHA

MEDICARE:   JOSEPH  BALCHA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172A00000XDriverLC001675083MO

General Provider Information

NPI Number : 1275177966
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH BALCHA
Provider Business Mailing Address
First Line : 4742 NW FLINTRIDGE RD
Second Line :
City : RIVERSIDE
State : MO
Zip : 64150-1108
Country : US
Telephone Number : 816-277-5975
Fax Number :
Provider Business Practice Location Address
First Line : 3419 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1910
Country : US
Telephone Number : 816-277-5975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2019
Last Update Date : 11/20/2019

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Directions to “ JOSEPH BALCHA ” Practice Location

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