Organization
JOHN E BALMER JR., DO
Active
Other names
Canadohta Lake Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA M BALMER RN (OFFICE MANAGER)
(814) 654-7334
Entity
Organization
Contact information
Practice address
35255 BROWN HILL RD, UNION CITY, PA 16438
(814) 694-2339
(814) 694-2176
Mailing address
PO BOX 211, SPARTANSBURG, PA 16434
(814) 654-7334
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001511070
—
PA
01
—
870298
BLUE SHIELD
PA
Enumeration date
12/06/2006
Last updated
12/20/2019
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