Organization
DEHAVEN DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT JUDSON BALCH III D.O. (PHYSICIAN)
(817) 984-6210
Entity
Organization
Contact information
Practice address
6116 OAKBEND TRL, SUITE 106, FORT WORTH, TX 76132-3925
(817) 984-6210
(817) 984-6216
Mailing address
6116 OAKBEND TRL, SUITE 106, FORT WORTH, TX 76132-3925
(817) 984-6210
(817) 984-6216
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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