Provider Demographics
NPI:1811759707
Name:BALISKY, SABRINA
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:BALISKY
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 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-3229
Mailing Address - Fax:
Practice Address - Street 1:9514 GRAVELLY LAKE DR SW STE W18
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-1514
Practice Address - Country:US
Practice Address - Phone:253-433-7140
Practice Address - Fax:253-433-7190
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12199225100000X
MT27320225100000X
WA225100000X
WACP036990T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist