Provider Demographics
NPI:1104716570
Name:BALAN, ANAAMIKA KRITHI
Entity type:Individual
Prefix:
First Name:ANAAMIKA
Middle Name:KRITHI
Last Name:BALAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5744 THOMASTON RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31220-5455
Mailing Address - Country:US
Mailing Address - Phone:706-339-8215
Mailing Address - Fax:
Practice Address - Street 1:5744 THOMASTON RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31220-5455
Practice Address - Country:US
Practice Address - Phone:706-339-8215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer