MEDICARE: BRITTNEY BALBAS M.S., OTR/L

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
1	174400000X	Specialist	OT-1430	ID
2	225XP0200X	Pediatric Occupational Therapist	9565	MT

General Provider Information

NPI Number	:	1982091799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY BALBAS M.S., OTR/L

Provider Business Mailing Address
First Line	:	500 12TH AVE W STE 2A
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-3855
Country	:	US
Telephone Number	:	406-471-1117
Fax Number	:	406-309-2076

Provider Business Practice Location Address
First Line	:	500 12TH AVE W STE 2A
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-3855
Country	:	US
Telephone Number	:	406-471-1117
Fax Number	:	406-309-2076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2015
Last Update Date	:	01/12/2023

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