Provider Demographics
NPI:1902339351
Name:BALAS, ERIC (PTP)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BALAS
Suffix:
Gender:M
Credentials:PTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-0764
Mailing Address - Country:US
Mailing Address - Phone:603-356-6400
Mailing Address - Fax:
Practice Address - Street 1:3277 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5113
Practice Address - Country:US
Practice Address - Phone:603-356-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist